Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Navigation/Suche
- Forscher*innen
- Institutionen
- Projekte
- Publikationen
- Partner
- Geldgeber
- Ausstattung
- Knowhow
- Forschungsfelder
"Köpfe" der aktuellen Meldungen:
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Rodriguez-Riascos, JF; Vemulapalli, HS; Akin, I; Areiza, LA; Della, Rocca, DG; Eitel, I; Fink, T; Genovesi, S; Kefer, J; Zweiker, D; Prajapati, P; Srivathsan, K.
Left Atrial Appendage Occlusion in Patients with End-Stage Renal Disease: An Individual Patient-Level Meta-Analysis.
Europace. 2025;
Doi: 10.1093/europace/euaf198
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Zweiker David
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- BACKGROUND: Patients with end-stage renal disease (ESRD) and atrial fibrillation (AF) present a challenge for thromboembolic prevention, given their elevated risks of both thromboembolism and bleeding. Anticoagulants carry a higher bleeding risk in this population without clear evidence of thromboembolic benefit. This study aims to define the role of left atrial appendage occlusion (LAAO) as a preventive strategy for patients with ESRD. METHODS: A systematic literature review was conducted to identify studies reporting outcomes in patients with ESRD who underwent LAAO. Meta-analyses of aggregate and individual patient data were performed to evaluate acute and long-term outcomes and compare them with those of patients without ESRD. RESULTS: Seventeen studies reporting data from 24,127 patients, including 1,047 with ESRD, were included. Procedural complications were more common in patients with ESRD (RR 2.23; P = 0.02), with a pooled rate of 4% (95%CI, 1-9%). There was no significant difference in thromboembolic event rates during follow-up between the groups (IRR 1.44; P = 0.16), but major bleeding incidence was higher among patients with ESRD (IRR 1.84; P < 0.01). Individual patient-level data from seven studies comprising 4,745 patients (268 with ESRD) were obtained and analyzed. Similarly, there was no significant association between ESRD and stroke/TIA incidence (HR 1.22 95% CI 0.66-2.26), but major bleeding was higher on patients with ESRD (HR 1.65 95% CI 1.01-2.69). CONCLUSION: LAAO represents a feasible option for thromboembolic prevention in patients with ESRD, although these patients have an increased risk of complications and bleeding.