NYMC Faculty Publications
Cerebrovascular Accidents and Mortality Following Left Atrial Appendage Occlusion in Patients With Moderate and Severe Chronic Renal Impairment: A Comprehensive Meta-Analysis
Author Type(s)
Faculty
DOI
10.1016/j.jscai.2024.101606
Journal Title
Journal of the Society for Cardiovascular Angiography & Interventions
First Page
101606
Document Type
Article
Publication Date
5-1-2024
Department
Medicine
Disciplines
Medicine and Health Sciences
Abstract
Background
Left Atrial Appendage Occlusion (LAAO)is as an effective approach of preventing stroke in individuals suffering from persistent atrial fibrillation. Chronic kidney dysfunction breaks down the coagulation system, giving rise to an unforeseen outcome post LAAO. We aimed to assess mortality and cerebrovascular events subsequent to LAAO in patients with various stages of chronic renal disease.
Methods
Studies comparing post- LAAO mortality rate and stroke incidence between CKD and non-CKD patients were considered eligible to be analyzed. Also, a meta-analysis was planned to observe whether the mentioned outcomes occurred while end-stage renal disease (ESRD) or not. All statistical analyses were performed using R software.
Results
13 investigations comprising 56041 patients were included. Post-LAAO mortality rate seemed to be higher in those having concomitant CKD (OR= 2.46[2.00-3.03], I2= 0%). However stroke/TIA incidence did not indicate a significant difference between the groups. ESRD was associated with a higher odds of mortality (OR= 3.19[1.22-8.38], I2= 82%) and stroke/TIA (OR= 4.17[2.97-5.85], I2= 0%) following LAAO.
Conclusions
Our findings revealed that the efficacy of LAAO might not be different between individuals with or without CKD. However, the mortality rate was still higher. On the other hand, ESRD patients seemed to show considerably poorer outcomes following the procedure. This makes a huge demand for researchers to design highly qualified clinical trials to observe which treatment strategy (novel anticoagulants or LAAO) will be more successful managing AF while severe CKD.
Recommended Citation
Gupta, R., Ghaseminejad-Raeini, A., Esmaeili, S., Shirinejad, A., Sood, A., Aronow, W. S., & Patel, N. (2024). Cerebrovascular Accidents and Mortality Following Left Atrial Appendage Occlusion in Patients With Moderate and Severe Chronic Renal Impairment: A Comprehensive Meta-Analysis. Journal of the Society for Cardiovascular Angiography & Interventions, 3 (5), 101606. https://doi.org/10.1016/j.jscai.2024.101606
