Open AccessLeft atrial appendage occlusion for stroke prevention in diabetes mellitus patients with atrial fibrillation: Long‐term results
Author(s) -
Litwinowicz Radoslaw,
Bartus Magdalena,
Ceranowicz Piotr,
Brzezinski Maciej,
Kapelak Bogusław,
Lakkireddy Dhanunjaya,
Bartus Krzysztof
Publication year - 2019
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12824
Subject(s) - medicine , atrial fibrillation , antithrombotic , diabetes mellitus , stroke (engine) , cardiology , left atrial appendage occlusion , concomitant , thromboembolic stroke , occlusion , heart failure , retrospective cohort study , surgery , warfarin , endocrinology , mechanical engineering , engineering
Background Concomitant diabetes mellitus (DM) in atrial fibrillation (AF) may increase the risk of thromboembolism. Left atrial appendage occlusion (LAAO) is an alternative treatment in AF patients in whom antithrombotic therapy is ineffective or contraindicated. The aim of this study was to evaluate the long‐term efficacy of LAAO in DM patients with AF. Methods A retrospective study was conducted in 139 patients who had undergone LAAO and were categorized into two groups: 28 patients with DM and 111 patients without DM. Overall, the follow‐up period was 530 patient‐years. Results Mean CHADS 2 and CHA 2 DS 2 ‐VASc scores were higher in patients with than without DM (2.6 vs 1.7 [ P < 0.001] and 3.5 vs 2.8 [ P = 0.056], respectively). There were no significant differences between the two groups in terms of HAS‐BLED scores and other patient factors (sex, age, heart failure, hypertension, previous stroke or transient ischemic attack, peripheral vascular disease) that may increase the risk of thromboembolism based on CHA 2 DS 2 ‐VASc. The mean follow‐up period was 51.6 and 50 months in patients with DM and without DM, respectively. Comparing patients with and without DM, there were no significant differences in thromboembolic events (4% vs 1.9%), severe bleeding (0% vs 3.1%), or mortality (4% vs 5.9%). The estimated reductions in thromboembolic and bleeding risk were 77% and 100%, respectively, for patients with DM, compared with 85% and 62%, respectively, for patients without DM. Conclusion The present study indicates that LAAO in AF patients with DM has similar safety endpoints and long‐term efficacy as LAAO in patients without DM.