Single Versus Dual Antiplatelet Therapy following Left Atrial Appendage Occlusion in Patients With High Bleeding Risk

Curr Probl Cardiol. 2022 Sep;47(9):101269. doi: 10.1016/j.cpcardiol.2022.101269. Epub 2022 May 26.

Abstract

Our study aims to compare the utility of single antiplatelet therapy (SAPT) with dual antiplatelet therapy (DAPT) following Left atrial appendage occlusion in patients whose post-procedural oral anticoagulation therapy was deemed high-risk or contraindicated. A total of 14 observational studies with 3,151 patients were included. Our study demonstrates that SAPT and DAPT were similar in preventing device-related thrombosis. Although SAPT and DAPT had a tendency toward a higher risk for stroke and major bleeding respectively, these differences did not reach statistical significance. Large-scale Randomized Controlled Studies are warranted to validate if our results could be translated into clinical practice.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Atrial Appendage* / surgery
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / drug therapy
  • Drug Therapy, Combination
  • Hemorrhage / chemically induced
  • Hemorrhage / drug therapy
  • Humans
  • Platelet Aggregation Inhibitors / adverse effects
  • Stroke* / etiology
  • Stroke* / prevention & control
  • Treatment Outcome

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors