Comparing Effectiveness and Safety of Left Atrial Appendage Closure Devices: A Network Meta-Analysis of Randomized Controlled Trials
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F25%3A43929088" target="_blank" >RIV/00064173:_____/25:43929088 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11120/25:43929088
Result on the web
<a href="https://doi.org/10.1002/clc.70217" target="_blank" >https://doi.org/10.1002/clc.70217</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1002/clc.70217" target="_blank" >10.1002/clc.70217</a>
Alternative languages
Result language
angličtina
Original language name
Comparing Effectiveness and Safety of Left Atrial Appendage Closure Devices: A Network Meta-Analysis of Randomized Controlled Trials
Original language description
INTRODUCTION: Atrial fibrillation-related stroke is a leading cause of morbidity and mortality. The comparative effectiveness and safety of left atrial appendage closure (LAAC) devices, compared with one another and with anticoagulation, is unclear. METHODS: We conducted a systematic review and network meta-analysis (NMA) of all clinical trials comparing the Watchman and Amplatzer Amulet LAAC devices with each other or with warfarin or direct oral anticoagulants (DOACs). The primary comparison was between LAAC devices with secondary comparisons to anticoagulation. The primary effectiveness outcomes were any stroke and all-cause death. Safety outcomes included any thromboembolism, device embolization, and pericardial effusion. RESULTS: There were 476 articles identified from the search and 6 eligible RCTs were included (n = 3666). There was no difference in the risk of stroke with Amulet versus Watchman (RR = 1.48, 95% CI: 0.64-3.46, I(2) = 41.3%), nor in the risk of death (RR = 1.00, 95% CI: 0.59-1.70, I(2) = 45.0%). Risk of thromboembolism was not significantly different with Amulet versus Watchman (RR = 0.73, 95% CI: 0.18-2.97, I(2) = 0%), nor was risk of device embolization (RR = 2.29, 95% CI: 0.71, 7.43, I(2) = 0%). Both devices exhibited increased risk of pericardial effusion compared with warfarin, with Amulet at highest relative risk (RR = 27.08, 95% CI: 3.53-207.98, I(2) = 0%) followed by Watchman (RR = 12.79, 95% CI: 1.73-94.85, I(2) = 0%). Amulet also carried higher relative risk of pericardial effusion than Watchman (RR = 2.12, 95% CI: 1.45-3.09). CONCLUSION: In this NMA, the Amulet and Watchman LAAC devices were associated with similar risks for stroke, mortality, thromboembolism, and device embolization. Pericardial effusion risk was higher with Amulet than Watchman.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
—
Continuities
N - Vyzkumna aktivita podporovana z neverejnych zdroju
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Clinical Cardiology
ISSN
0160-9289
e-ISSN
1932-8737
Volume of the periodical
48
Issue of the periodical within the volume
11
Country of publishing house
US - UNITED STATES
Number of pages
8
Pages from-to
"e70217"
UT code for WoS article
001620104800001
EID of the result in the Scopus database
2-s2.0-105022638540