کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2940158 1177021 2014 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Percutaneous Left Atrial Appendage Occlusion for Stroke Prophylaxis in Nonvalvular Atrial Fibrillation : A Systematic Review and Analysis of Observational Studies
ترجمه فارسی عنوان
عوارض جانبی پرولیال چپ برای پیشگیری از سکته مغزی در فیبریلاسیون دهلیزی غیرواقعی: یک بررسی سیستماتیک و تجزیه و تحلیل مطالعات مشاهدات
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

ObjectivesThe goal of this study was to provide a systematic review and analysis of observational studies on percutaneous left atrial appendage (LAA) occlusion for stroke prophylaxis in nonvalvular atrial fibrillation (NVAF).BackgroundA recent randomized controlled trial in patients with NVAF suggested noninferiority of percutaneous LAA occlusion versus medical management for stroke prevention. However, the use of percutaneous devices remains controversial because of limited literature on their efficacy and safety. We performed a systematic analytical review of existing observational studies to assess the rate of neurological events for patients treated with occlusion devices.MethodsA comprehensive search of the Medline, Scopus, and Web of Science databases from inception through August 1, 2013, was conducted using pre-defined criteria. We included studies reporting implantation in at least 10 patients and a follow-up of 6 months or more.ResultsIn 17 eligible studies, a total of 1,052 devices were implanted in 1,107 patients with 1,586.4 person-years (PY) of follow-up. The adjusted incidence rate of stroke was 0.7/100 PY (95% confidence interval [CI]: 0.3 to 1.1/100 PY), of transient ischemic attacks was 0.5/100 PY (95% CI: 0.1 to 1.8/100 PY), and of combined neurological events (strokes or transient ischemic attacks) was 1.1/100 PY (95% CI: 0.6 to 1.6/100 PY). Access site vascular complications and pericardial effusion were the most commonly observed procedural complications at a rate of 8.6% (95% CI: 6.3% to 11.7%) and 4.3% (95% CI: 3.1% to 5.9%), respectively.ConclusionsOur systematic review suggested comparable efficacy of LAA occlusion devices compared with historical controls treated with adjusted-dose warfarin and other anticoagulation strategies for prevention of stroke in patients with NVAF.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: JACC: Cardiovascular Interventions - Volume 7, Issue 3, March 2014, Pages 296–304
نویسندگان
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