LAAO outcomes significantly worse among women
Women face a heightened risk of poor in-hospital outcomes after left atrial appendage occlusion (LAAO), according to a new analysis published in JAMA Cardiology.
The study’s authors examined data from 597 different hospitals that participated in the National Cardiovascular Data Registry’s LAAO Registry. More than 49,000 patients underwent LAAO with the Watchman device from January 2016 to June 2019. While 58.7% were men, the mean age was 76.1 years old.
Women did tend to be slightly older at the time of the LAAO (76.5 years old vs. 75.8 years old) and were more likely to have paroxysmal atrial fibrillation (AFib) (59% vs. 50%).
Overall, the rates of adverse events were 6.3% for female patients and 3.9% for male patients. Women also experienced higher rates of certain complications, including major bleeding events (1.7% vs. 0.8%) and pericardial effusion requiring drainage (1.2% vs. 0.5%), and were more likely to stay in the hospital for more than one day.
The risk of an aborted or canceled procedures, however, was nearly identical between the two groups.
Researchers did offer several potential ways that healthcare providers can work to reverse this trend among women undergoing LAAO.
“Although we cannot fully elucidate the causes of the increased risk of adverse events experienced by women, several strategies may mitigate procedural risk, including ultrasonography-guided venous access, preprocedural imaging to evaluate cardiac function, LAA size and morphology to guide equipment and device selection, developing proficiency with LAAO devices, and continued development of safer devices,” wrote lead author Douglas Darden, MD, from the department of medicine at the University of California, San Diego, and colleagues. “We must continue to advocate for increased participation of women in clinical trials to better inform clinical decision-making and adequately delineate sex-based safety and efficacy outcomes.”
The full study is available here.
Related Left Atrial Appendage Occlusion Content:
Older LAAO patients, especially women, face a higher risk of complications
Same-day discharge after LAAO associated with strong outcomes, significant cost savings
New LAA occluder technology and the debate on echo vs. CT image guidance
VIDEO: Advances in left atrial appendage occlusion technology — Interview with Devi Nair, MD
Amulet vs. Watchman: LAA occluder devices compared in new head-to-head trial
Abbott’s LAA closure solution for AFib patients gains FDA approval
What peridevice leaks after LAAO mean for patient health
Key interventional cardiology takeaways from ACC.22
Confirmed: Watchman FLX LAAC device safe for nonvalvular AFib patients
Cardiologist makes history, completes LAAO with new 3D ICE catheter
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.