Head-to-head comparison between left atrial appendage occlusion and non-vitamin K oral anticoagulants in non-valvular atrial fibrillation patients: A systematic review and meta-analysis study
Head-to-head comparison between left atrial appendage occlusion and non-vitamin K oral anticoagulants in non-valvular atrial fibrillation patients: A systematic review and meta-analysis study
Waranugraha et al., 2024 | Trends Cardiovasc Med | Meta Analysis
Citation
Waranugraha Yoga, Lin Lian-Yu, Tsai Chia-Ti. Head-to-head comparison between left atrial appendage occlusion and non-vitamin K oral anticoagulants in non-valvular atrial fibrillation patients: A systematic review and meta-analysis study. Trends Cardiovasc Med. 2024-May;34(4):225-233. doi:10.1016/j.tcm.2023.02.002
Abstract
Left atrial appendage occlusion (LAAO) was found to be non-inferior to warfarin. In non-valvular atrial fibrillation (AF), there is still a scarcity of data comparing LAAO versus non-vitamin K oral anticoagulants (NOACs). Our purpose was to compare the clinical benefits between LAAO and NOACs in non-valvular AF patients. The patient, intervention, comparison, and outcome principles were used to develop the research question in this systematic review and meta-analysis. Literature searches were conducted in online scientific databases such as ProQuest, PubMed, and ScienceDirect. All important information was extracted. The random-effect model was applied to estimate all pooled effects. The Mantel-Haenszel statistical method was used to determine the pooled risk ratio (RR) and 95% confidence interval (CI). A total of 4411 participants from 5 studies were involved. LAAO significantly decreased the cardiovascular mortality risk compared to NOACs (RR = 0.56; 95% CI = 0.42 to 0.75; p <0.01). Major bleeding risk in the LAAO group was significantly lower than in the NOACs group (RR = 0.66; RR = 0.53 to 0.82; p <0.01). A significantly lower risk of major bleeding or non-major bleeding in the patients receiving LAAO than NOACs was also observed in this meta-analysis (RR = 0.66; 95% CI = 0.54 to 0.81; p <0.01). LAAO was superior to the NOACs in reducing cardiovascular mortality, major bleeding, and major or non-major bleeding risks in non-valvular AF patients. In high-risk thromboembolism and bleeding patients, LAAO can be considered first as a long-term treatment strategy.
Key Findings
In high-risk thromboembolism and bleeding patients, LAAO can be considered first as a long-term treatment strategy.
Outcomes Measured
- Requires manual extraction
Population
| Field | Value |
|---|---|
| Population | See abstract |
| Sample Size | 4411 |
| Age Range | See abstract |
| Condition | See abstract |
MeSH Terms
- Aged
- Female
- Humans
- Male
- Middle Aged
- Administration, Oral
- Anticoagulants
- Atrial Appendage
- Atrial Fibrillation
- Cardiac Catheterization
- Factor Xa Inhibitors
- Hemorrhage
- Risk Assessment
- Risk Factors
- Stroke
- Treatment Outcome
Evidence Classification
- Level: Meta Analysis
- Publication Types: Systematic Review, Journal Article, Meta-Analysis
- Vertical: vitamin-k
Provenance
- PMID: 36775218
- DOI: 10.1016/j.tcm.2023.02.002
- PMCID: Not in PMC
- Verified: 2026-04-09 via PubMed E-utilities API
Source extracted via PubMed E-utilities API on 2026-04-09