{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:05:38Z","timestamp":1757700338231,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004362","name":"Schweizerische Herzstiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004362","name":"Schweizerische Herzstiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare long\u2010term clinical outcomes after left atrial appendage closure with the Amplatzer Cardiac Plug (ACP) and Amulet.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The Amulet was designed to improve clinical outcomes of first\u2010generation ACP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three Amplatzer registries (Bern, Coburg, Zurich), with enrollment of patients from 2009 to 2018, were retrospectively analyzed. The primary safety endpoint was a composite of major peri\u2010procedural complications and major bleedings, the primary efficacy endpoint included stroke, systemic embolism, and cardiovascular\/unexplained death. The net clinical benefit was a combination of all above\u2010mentioned hazards.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of consecutive 563 patients (344 ACP vs. 219 Amulet) with a mean follow\u2010up of 2.9\u2009\u00b1\u20091.6 and 1.9\u2009\u00b1\u20090.9\u2009years were included. Mean age (74.4\u2009\u00b1\u20099.9 [ACP] vs. 74.4\u2009\u00b1\u20099.1 [Amulet] years), stroke (CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score 4.4\u2009\u00b1\u20091.6 vs. 4.6\u2009\u00b1\u20091.7), and bleeding risk (HAS\u2010BLED score 3.2\u2009\u00b1\u20091.1 vs. 3.2\u2009\u00b1\u20090.9) were comparable. The primary endpoints of efficacy (72\/998, 7.2% [ACP] vs. 43\/417, 10.3% [Amulet]; hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.44\u20131.02, <jats:italic>p<\/jats:italic> = .062), safety (40\/998, 4.0% vs. 18\/417, 4.3%; HR, 1.15; 95% CI, 0.53\u20132.51, <jats:italic>p<\/jats:italic> = .72), and the net clinical benefit (101\/998, 10.1% vs. 55\/417, 13.4%; HR, 0.73; 95% CI, 0.49\u20131.07, <jats:italic>p<\/jats:italic> = .11) were similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the long term, left atrial appendage closure with first and second\u2010generation Amplatzer devices provided similar efficacy, safety, and net clinical benefit. Clinical outcomes may be rather determined by implantation technique and hemodynamics, but not by the design modifications of the Amulet.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28530","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T07:36:54Z","timestamp":1571643414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Long\u2010term clinical outcomes of Amplatzer cardiac plug versus Amulet occluders for left atrial appendage closure"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6814-5236","authenticated-orcid":false,"given":"Caroline","family":"Kleinecke","sequence":"first","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Cheikh\u2010Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Schnupp","sequence":"additional","affiliation":[{"name":"Department of Cardiology Klinikum Coburg  Coburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mate","family":"Fankhauser","sequence":"additional","affiliation":[{"name":"Cardiology, Cardiovascular Department University Hospital of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"Nietlispach","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland, and Cardiovascular Center Zurich Hirslanden Klinik im Park  Zurich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jai\u2010Wun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Charit\u00e9 Berlin \u2013 University Medicine, Campus Benjamin Franklin  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