Impact of gender in patients with device‐related thrombosis after left atrial appendage closure – A sub‐analysis from the multicenter EUROC‐DRT‐registry
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| Format: | Artículo Open Access |
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Wiley
2024
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| author | Jacqueline Saw Vivian Vij Roberto Galea Kerstin Piayda Dominik Nelles Lara Vogt Steffen Gloekler Monika Fürholz Bernhard Meier Lorenz Räber Gilles O'Hara Dabit Arzamendi Victor Agudelo Lluis Asmarats Xavier Freixa Eduardo Flores‐Umanzor Ole De Backer Lars Sondergaard Luis Nombela‐Franco Pablo Salinas Kasper Korsholm Jens Erik Nielsen‐Kudsk Tobias Zeus Felix Operhalski Boris Schmidt Gilles Montalescot Paul Guedeney Xavier Iriart Noelie Miton Thomas Gilhofer Laurent Fauchier Egzon Veliqi Felix Meincke Nils Petri Peter Nordbeck Rocio Gonzalez‐Ferreiro Ignacio Cruz‐González Deepak L Bhatt Alessandra Laricchia Antonio Mangieri Heyder Omran Jan Wilko Schrickel Thomas Beiert Josep Rodes‐Cabau Georg Nickenig Horst Sievert Alexander Sedaghat Shazia Afzal |
| author_facet | Jacqueline Saw Vivian Vij Roberto Galea Kerstin Piayda Dominik Nelles Lara Vogt Steffen Gloekler Monika Fürholz Bernhard Meier Lorenz Räber Gilles O'Hara Dabit Arzamendi Victor Agudelo Lluis Asmarats Xavier Freixa Eduardo Flores‐Umanzor Ole De Backer Lars Sondergaard Luis Nombela‐Franco Pablo Salinas Kasper Korsholm Jens Erik Nielsen‐Kudsk Tobias Zeus Felix Operhalski Boris Schmidt Gilles Montalescot Paul Guedeney Xavier Iriart Noelie Miton Thomas Gilhofer Laurent Fauchier Egzon Veliqi Felix Meincke Nils Petri Peter Nordbeck Rocio Gonzalez‐Ferreiro Ignacio Cruz‐González Deepak L Bhatt Alessandra Laricchia Antonio Mangieri Heyder Omran Jan Wilko Schrickel Thomas Beiert Josep Rodes‐Cabau Georg Nickenig Horst Sievert Alexander Sedaghat Shazia Afzal Jacqueline Saw Vivian Vij Roberto Galea Kerstin Piayda Dominik Nelles Lara Vogt Steffen Gloekler Monika Fürholz Bernhard Meier Lorenz Räber Gilles O'Hara Dabit Arzamendi Victor Agudelo Lluis Asmarats Xavier Freixa Eduardo Flores‐Umanzor Ole De Backer Lars Sondergaard Luis Nombela‐Franco Pablo Salinas Kasper Korsholm Jens Erik Nielsen‐Kudsk Tobias Zeus Felix Operhalski Boris Schmidt Gilles Montalescot Paul Guedeney Xavier Iriart Noelie Miton Thomas Gilhofer Laurent Fauchier Egzon Veliqi Felix Meincke Nils Petri Peter Nordbeck Rocio Gonzalez‐Ferreiro Ignacio Cruz‐González Deepak L Bhatt Alessandra Laricchia Antonio Mangieri Heyder Omran Jan Wilko Schrickel Thomas Beiert Josep Rodes‐Cabau Georg Nickenig Horst Sievert Alexander Sedaghat Shazia Afzal |
| collection | Wiley Open Access |
| contents | Impact of gender in patients with device‐related thrombosis after left atrial appendage closure – A sub‐analysis from the multicenter EUROC‐DRT‐registry Jacqueline Saw Vivian Vij Roberto Galea Kerstin Piayda Dominik Nelles Lara Vogt Steffen Gloekler Monika Fürholz Bernhard Meier Lorenz Räber Gilles O'Hara Dabit Arzamendi Victor Agudelo Lluis Asmarats Xavier Freixa Eduardo Flores‐Umanzor Ole De Backer Lars Sondergaard Luis Nombela‐Franco Pablo Salinas Kasper Korsholm Jens Erik Nielsen‐Kudsk Tobias Zeus Felix Operhalski Boris Schmidt Gilles Montalescot Paul Guedeney Xavier Iriart Noelie Miton Thomas Gilhofer Laurent Fauchier Egzon Veliqi Felix Meincke Nils Petri Peter Nordbeck Rocio Gonzalez‐Ferreiro Ignacio Cruz‐González Deepak L Bhatt Alessandra Laricchia Antonio Mangieri Heyder Omran Jan Wilko Schrickel Thomas Beiert Josep Rodes‐Cabau Georg Nickenig Horst Sievert Alexander Sedaghat Shazia Afzal Echocardiography AbstractBackgroundDevice‐related thrombosis (DRT) is a common finding after left atrial appendage closure (LAAC) and is associated with worse outcomes. As women are underrepresented in clinical studies, further understanding of sex differences in DRT patients is warranted.Methods and ResultsThis sub‐analysis from the EUROC‐DRT‐registry compromises 176 patients with diagnosis of DRT after LAAC. Women, who accounted for 34.7% (61/176) of patients, were older (78.0 ± 6.7 vs. 74.9 ± 9.1 years, p = .06) with lower rates of comorbidities. While DRT was detected significantly later in women (173 ± 267 vs. 127 ± 192 days, p = .01), anticoagulation therapy was escalated similarly, mainly with initiation of novel oral anticoagulant (NOAC), vitamin K antagonist (VKA) or heparin. DRT resolution was achieved in 67.5% (27/40) of women and in 75.0% (54/72) of men (p = .40). In the remaining cases, an intensification/switch of anticoagulation was conducted in 50.% (9/18) of men and in 41.7% (5/12) of women. Final resolution was achieved in 72.5% (29/40) cases in women, and in 81.9% (59/72) cases in men (p = .24). Women were followed‐up for a similar time as men (779 ± 520 vs. 908 ± 687 days, p = .51). Kaplan–Meier analysis revealed no difference in mortality rates in women (Hazard Ratio [HR]: 1.73, 95%‐Confidence interval [95%‐CI]: .68–4.37, p = .25) and no differences in stroke (HR: .83, 95%‐CI: .30–2.32, p = .72) within 2 years after LAAC.ConclusionEvaluation of risk factors and outcome revealed no differences between men and women, with DRT in women being diagnosed significantly later. Women should be monitored closely to assess for DRT formation/resolution. Treatment strategies appear to be equally effective. 10.1111/echo.15888 http://creativecommons.org/licenses/by-nc/4.0/ |
| doi_str_mv | 10.1111/echo.15888 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_echo_15888 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Impact of gender in patients with device‐related thrombosis after left atrial appendage closure – A sub‐analysis from the multicenter EUROC‐DRT‐registry Jacqueline Saw Vivian Vij Roberto Galea Kerstin Piayda Dominik Nelles Lara Vogt Steffen Gloekler Monika Fürholz Bernhard Meier Lorenz Räber Gilles O'Hara Dabit Arzamendi Victor Agudelo Lluis Asmarats Xavier Freixa Eduardo Flores‐Umanzor Ole De Backer Lars Sondergaard Luis Nombela‐Franco Pablo Salinas Kasper Korsholm Jens Erik Nielsen‐Kudsk Tobias Zeus Felix Operhalski Boris Schmidt Gilles Montalescot Paul Guedeney Xavier Iriart Noelie Miton Thomas Gilhofer Laurent Fauchier Egzon Veliqi Felix Meincke Nils Petri Peter Nordbeck Rocio Gonzalez‐Ferreiro Ignacio Cruz‐González Deepak L Bhatt Alessandra Laricchia Antonio Mangieri Heyder Omran Jan Wilko Schrickel Thomas Beiert Josep Rodes‐Cabau Georg Nickenig Horst Sievert Alexander Sedaghat Shazia Afzal Echocardiography Impact of gender in patients with device‐related thrombosis after left atrial appendage closure – A sub‐analysis from the multicenter EUROC‐DRT‐registry Jacqueline Saw Vivian Vij Roberto Galea Kerstin Piayda Dominik Nelles Lara Vogt Steffen Gloekler Monika Fürholz Bernhard Meier Lorenz Räber Gilles O'Hara Dabit Arzamendi Victor Agudelo Lluis Asmarats Xavier Freixa Eduardo Flores‐Umanzor Ole De Backer Lars Sondergaard Luis Nombela‐Franco Pablo Salinas Kasper Korsholm Jens Erik Nielsen‐Kudsk Tobias Zeus Felix Operhalski Boris Schmidt Gilles Montalescot Paul Guedeney Xavier Iriart Noelie Miton Thomas Gilhofer Laurent Fauchier Egzon Veliqi Felix Meincke Nils Petri Peter Nordbeck Rocio Gonzalez‐Ferreiro Ignacio Cruz‐González Deepak L Bhatt Alessandra Laricchia Antonio Mangieri Heyder Omran Jan Wilko Schrickel Thomas Beiert Josep Rodes‐Cabau Georg Nickenig Horst Sievert Alexander Sedaghat Shazia Afzal Echocardiography AbstractBackgroundDevice‐related thrombosis (DRT) is a common finding after left atrial appendage closure (LAAC) and is associated with worse outcomes. As women are underrepresented in clinical studies, further understanding of sex differences in DRT patients is warranted.Methods and ResultsThis sub‐analysis from the EUROC‐DRT‐registry compromises 176 patients with diagnosis of DRT after LAAC. Women, who accounted for 34.7% (61/176) of patients, were older (78.0 ± 6.7 vs. 74.9 ± 9.1 years, p = .06) with lower rates of comorbidities. While DRT was detected significantly later in women (173 ± 267 vs. 127 ± 192 days, p = .01), anticoagulation therapy was escalated similarly, mainly with initiation of novel oral anticoagulant (NOAC), vitamin K antagonist (VKA) or heparin. DRT resolution was achieved in 67.5% (27/40) of women and in 75.0% (54/72) of men (p = .40). In the remaining cases, an intensification/switch of anticoagulation was conducted in 50.% (9/18) of men and in 41.7% (5/12) of women. Final resolution was achieved in 72.5% (29/40) cases in women, and in 81.9% (59/72) cases in men (p = .24). Women were followed‐up for a similar time as men (779 ± 520 vs. 908 ± 687 days, p = .51). Kaplan–Meier analysis revealed no difference in mortality rates in women (Hazard Ratio [HR]: 1.73, 95%‐Confidence interval [95%‐CI]: .68–4.37, p = .25) and no differences in stroke (HR: .83, 95%‐CI: .30–2.32, p = .72) within 2 years after LAAC.ConclusionEvaluation of risk factors and outcome revealed no differences between men and women, with DRT in women being diagnosed significantly later. Women should be monitored closely to assess for DRT formation/resolution. Treatment strategies appear to be equally effective. 10.1111/echo.15888 http://creativecommons.org/licenses/by-nc/4.0/ |
| title | Impact of gender in patients with device‐related thrombosis after left atrial appendage closure – A sub‐analysis from the multicenter EUROC‐DRT‐registry |
| topic | Echocardiography |
| url | https://onlinelibrary.wiley.com/doi/10.1111/echo.15888 |