Ischaemic stroke prevention in patients with atrial fibrillation and high bleeding risk: Opportunities and challenges for percutaneous left atrial appendage occlusion

Europace

Volumn 16, Issue 5, 2014, Pages 626-630

  Lewalter, T ^a,b   Kanagaratnam, P ^c   Schmidt, B ^d   Rosenqvist, M ^e   Nielsen Kudsk, J E ^f   Ibrahim, R ^g   Albers, B A ^h   Camm, A J ⁱ  

^a Isarklinikum Munich   (Germany)

^b UNIVERSITY OF BONN   (Germany)

^c IMPERIAL COLLEGE HEALTHCARE NHS TRUST   (United Kingdom)

^d CARDIOANGIOLOGISCHES CENTRUM BETHANIEN   (Germany)

^e KAROLINSKA INSTITUTE   (Sweden)

^f AARHUS UNIVERSITY HOSPITAL   (Denmark)

^g MONTREAL HEART INSTITUTE   (Canada)

^h Albers Clinical Evidence Consultancy ^*  (Netherlands)

ⁱ ST GEORGE'S UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

Atrial fibrillation; bleeding; Left atrial appendage occlusion; Strok

Indexed keywords

ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT;

AMPLATZER VASCULAR PLUG; ANTICOAGULANT THERAPY; BLEEDING; BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CARDIOVASCULAR SURGERY; CLINICAL PRACTICE; COMORBIDITY; CONSENSUS; FOLLOW UP; GASTROINTESTINAL HEMORRHAGE; HEART ATRIUM FIBRILLATION; HUMAN; KIDNEY DISEASE; LEFT ATRIAL APPENDAGE CLOSURE DEVICE; META ANALYSIS (TOPIC); MULTICENTER STUDY (TOPIC); PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; RISK BENEFIT ANALYSIS; RISK FACTOR; VASCULAR AMYLOIDOSIS; ATRIAL FIBRILLATION; CHEMICALLY INDUCED; COMPLICATION; ENDOVASCULAR SURGERY; HEART ATRIUM APPENDAGE; PROCEDURES; SEPTAL OCCLUDER; STROKE; SURGERY;

ANTICOAGULANTS; ATRIAL APPENDAGE; ATRIAL FIBRILLATION; BRAIN ISCHEMIA; CEREBRAL HEMORRHAGE; ENDOVASCULAR PROCEDURES; GASTROINTESTINAL HEMORRHAGE; HUMANS; PLATELET AGGREGATION INHIBITORS; SEPTAL OCCLUDER DEVICE; STROKE;

EID: 84900296833     PISSN: 10995129     EISSN: 15322092     Source Type: Journal    
DOI: 10.1093/europace/euu069     Document Type: Review

References (47)

1. Hart R, Pearce L, Aguilar M. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857-67.
2. Palnum K, Mehnert F, Andersen G, IngemanA, Krog B, Bartels Pet al. Medical prophylaxis following hospitalization for ischemic stroke: age- and sex-related differences and relation to mortality. Cerebrovasc Dis 2010; 30: 556-66.
3. Gallagher A, Rietbrock S, Plumb J, van Staa T. Initiation and persistence of warfarin or aspirin in patients with chronic atrial fibrillation in general practice: do the appropriate patients receive stroke prophylaxis? J Thromb Haemost 2008; 6: 1500-6.
4. Srivastava A, Hudson M, Hamoud I, Cavalcante J, Pai C, Kaatz S. Examining warfarin underutilization rates in patients with atrial fibrillation: detailed chart review essential to capture contraindications to warfarin therapy. Thromb J 2008; 6: 6. (doi: 10.1186/1477-9560-6-6).
5. Connolly S, Ezekowitz M, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139-51.
6. Giugliano R, Ruff C, Braunwald E, Murphy S, Wiviott S, Halperin J et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013; 369: 2093-104.
7. Patel M, Mahaffey K, Garg J, Pan G, Singer D, HackeWet al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883-91.
8. Granger C, Alexander J, McMurray J, Lopes R, Hylek E, Hanna M et al. Apixaban versus warfarin in patients with atrial fibrillation. New Eng J Med 2011; 365: 981-92.
9. Olesen J, Lip G, Lindhardsen J, LaneD, Ahlehoff O, HansenMet al. Risks of thromboembolismand bleeding with thromboprophylaxis in patients with atrial fibrillation: a net clinical benefit analysis using a 'real world' nationwide cohort study. Thromb Haemost 2011; 106: 739-49.
10. Banerjee A, Lane D, Torp-Pedersen C, Lip G. Net clinical benefit of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus no treatment in a 'real world' atrial fibrillation population: a modelling analysis based on a nationwide cohort study. Thromb Haemost 2012; 107: 584-9.
11. Olesen J, Lip G, Kamper A, Hommel K, Køber L, LaneD et al. Stroke and bleeding in atrial fibrillation with chronic kidney disease. New Eng J Med 2012; 367: 625-35.
12. Elliott M, Zimmerman D, Holden R. Warfarin anticoagulation in hemodialysis patients: a systematic review of bleeding rates. Am J Kidney Dis 2007; 50: 433-40.
13. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Europace 2012; 14: 1385-413.
14. Camm A, Lip G, De Caterina R, Savelieva I, Atar D, Hohnloser S et al. 2012 focused update of the ESC guidelines for the management of atrial fibrillation. Eur Heart J 2012; 33: 2719-47.
15. Heidbuchel H, Verhamme P, Alings M, Antz M, HackeW, Oldgren J et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013; 15: 625-51.
16. Pisters R, Lane D, Nieuwlaat R, de Vos C, Crijns H, Lip G.Anovel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093-100.
17. Charidimou A, Shakeshaft C, Werring D. Cerebral microbleeds on magnetic resonance imaging and anticoagulant-associated intracerebral hemorrhage risk. Front Neurol 2012; 3: 133.
18. Song T, Kim J, Lee H, Nam C, Nam H, Heo J et al. The frequency of cerebral microbleeds increases with CHADS2 scores in stroke patients with non-valvular atrial fibrillation. Eur J Neurol 2013; 20: 502-8.
19. Rosand J, Hylek E, O'Donnell H, Greenberg S.Warfarin-associated hemorrhage and cerebral amyloid angiopathy-a genetic and pathological study. Neurology 2000; 55: 947-51.
20. Goldstein J, Greenberg S. Should anticoagulation be resumed after intracerebral hemorrhage? Cleveland Clin J 2010; 77: 791-9.
21. Lip G, Huber K, Andreotti F, Arnesen H, Airaksinen J, Cuisset Tet al. Antithrombotic management of atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing coronary stenting: executive summary. Eur Heart J 2010; 31: 1311-8.
22. Khurram Z, Cho E, Minutello R, Bergman G, Parikh M, Naidu S et al. Combination therapy with aspirin, clopidogrel and warfarin following coronary stenting is associated with a significant risk of bleeding. J Invasive Cardiol 2006; 18: 162-4.
23. Sourgounis A, Lipiecki J, Lo T, Hamon M. Coronary stents and chronic anticoagulation. Circulation 2009; 119: 1682-8.
24. Witt D, Delate T, Garcia D, Clark N, Hylek E, AgenoWet al. Risk of thromboembolism, recurrent hemorrhage and death after warfarin therapy interruption for gastrointestinal tract bleeding. Arch Intern Med 2012; 172: 1484-91.
25. Lee S, Shin D, Hwang H, Kim J, Pak H, Lee M et al. Bleeding risk and major adverse events in patients with previous ulcer on oral anticoagulation therapy. Am J Cardiol 2012; 110: 373-7.
26. Hearnshaw S, Logan R, Lowe D, Travis S, Murphy M, Palmer K. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnosis and outcomes in the 2007 UK audit. Gut 2011; 60: 1327-35.
27. Glader E, Stegmayer B, Norrving B, Terént A, Hulter-Asberg K, Wester P et al. Large variations in the use of oral anticoagulants in stroke patients with atrial fibrillation: a Swedish national perspective. J Intern Med 2004; 255: 22-32.
28. O'Donnell M, OczkowskiW, Fang J, Kearon C, Silva J, Bradley C et al. Preadmission antithrombotic treatment and stroke severity in patients with atrial fibrillation and acute ischaemic stroke: an observational study. Lancet Neurol 2006; 5: 749-54.
29. Broukhim M, Halperin J. Stroke prevention in the high-risk atrial fibrillation patient: medical management. Curr Cardiol Rep 2010; 13: 9-17.
30. Flaker G, Gruber M, Connolly S, Goldman S, Chaparro S, Vahanian A et al. Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trials. Am Heart J 2006; 152: 967-73.
31. ShiremanT, HowardP, KresowikT, Ellerbeck E. Combined anticoagulant- antiplatelet use and major bleeding events in elderly atrial fibrillation patients. Stroke 2004; 35: 2362-7.
32. Reynolds M, Fahrbach K, Hauch O, Wygant G, Estok R, CellaC et al.Warfarin anticoagulation and outcomes in patients with atrial fibrillation-a systematic review and metaanalysis. Chest 2004; 126: 1938-1945.
33. Reddy V, Möbius-Winkler S, Miller M, Neuzil P, Schuler G, Wiebe J et al. Left atrial appendage closure with the watchman device in patients with a contraindication for oral anticoagulation. J Am Coll Cardiol 2013; 61: 2551-6.
34. Tzikas A. LAAO for stroke prevention in AF: multicenter experience with the amplatzer cardiac plug. Paper presented at: TCT, 2013; San Francisco, CA.
35. Walsh K. Left atrial appendage closure with the AMPLATZER cardiac plug: results of the European Post-Market Observational Study. Paper presented at: EuroPCR, 2012 May 15-18; Paris.
36. Meerkin D, Butnaru A, Dratva D, Tzivoni D. One-year outcomes following LAA occlusion in high-risk patients with atrial fibrillation. Paper presented at: EuroPCR, 2012 May 15-18; Paris.
37. Holmes D, Reddy V, Turi Z, Doshi S, Sievert H, Buchbinder M et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 2009; 374: 534-42.
38. ReddyV, Doshi S, Sievert H, Buchbinder M, Neuzil P, HuberK et al. Long term results of protect AF: the mortality effects of left atrial appendage closure versus warfarin for stroke prophylaxis in AF. Paper presented at: Heart Rhythm 2013, Late-Breaking Clinical Trials (abstract LB01-03 and updated presented results), 2013; Denver, Colorado, USA.
39. Urena M, Rodés-Cabau J, Freixa X, Saw J, Webb J, FreemanMet al. Percutaneous left atrial appendage closure with the amplatzer cardiac plug device in patients with nonvalvular atrial fibrillation and contraindications for anticoagulation therapy. J Am Coll Cardiol 2013; 62: 96-102.
40. Sievert H, Schillinger W, Lickfett L, Lopez-Minguez J, Omran H, Ormerod O et al. Long term follow-up from amplatzer cardiac plug European multicenter post market observational study. Eur Heart J 2013; 34: 394.
41. Lewalter T, Ibrahim R, Albers B, CammA. An update and current expert opinions on percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation. Europace 2013; 15: 652-6.
42. Chun K, Bordignon S, Urban V, Perrotta L, Dugo D, Fürnkranz A et al. Left atrial appendage closure followed by six weeks antithrombotic therapy - a prospective single center experience. Heart Rhythm 2013; 10: 1792-9.
43. Langbein ASA, Groschup G, Krug J, Ziegler V, Soda H, Schumacher B. Left atrial appendage occlusion with the watchman device: which postimplant anticoagulation regime is necessary? First results of the LAOTSE Trial. Clin Res Cardiol 2011; 100: V1562.
44. Schmidt B, Bordignon S, Fürnkranx A, Chun K. Short term dual platelet inhibition after LAA occluder implantation. Clin Res Cardiol 2012; 101: P462.
45. vanWalraven C, Hart R, Singer D, Laupacis A, Connolly S, Petersen Pet al. Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation-an individual patient meta-analysis. JAMA 2002; 288: 2441-8.
46. Huang E, Strate L, HoW, Lee S, Chan A. A prospective study of aspirin use and the risk of gastroinstestinal bleeding in men. PLoS ONE 2010; 12: e15721.
47. Huang E, Strate L, Ho W, Lee S, Chan A. Long term use of aspirin and the risk of gastrointestinal bleeding. Am J Med 2011; 124: 426-33.