Atrial fibrillation patients indicated for oral anticoagulation who had intracranial bleeding constitute a particularly difficult group with respect to their stroke risk management. In many cases these patients do not receive anticoagulation therapy due to concerns for recurrent intracranial bleeding or intracerebral hemorrhage (ICH).
Nielsen-Kudsk conducted a propensity score matched trial that compared 147 patients with LAA occlusion (LAAO) and 147 standard care patients matched according to stroke and bleeding risks (CHA2DS2-VASc and HAS-BLED scores).4
When comparing LAAO to standard care, LAAO showed a significant risk reduction of the following:
- Combined endpoint of ischemic stroke, major bleeding, mortality: 81% relative risk reduction
- Ischemic stroke: 65% relative risk reduction
- Major bleeding: 61% relative risk reduction
- Recurrent intracerebral hemorrhage: 71% relative risk reduction
- All-cause mortality: 92% relative risk reduction