{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:17:08Z","timestamp":1783469828504,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Objectives<\/jats:title><jats:p>Advanced chronic kidney disease (A\u2010CKD) combined with atrial fibrillation increases the risk of both thrombogenic and bleeding events. Left atrial appendage occlusion (LAAO) may be an alternative to oral anticoagulation to prevent thromboembolic events. We aimed to evaluate the outcomes of LAAO in patients with A\u2010CKD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Comparison at long\u2010term follow\u2010up of patients diagnosed with and without A\u2010CKD (eGFR&lt;30\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>) who underwent LAAO between 2009 and May 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred seventy\u2010three patients were included. Eighty\u2010one (14%) were diagnosed with A\u2010CKD. There were no differences in sex, age, and cardiovascular risk factors, except for diabetes which was more frequent in patients with A\u2010CKD. The control group had higher rates of stroke, both ischemic and hemorrhagic. There were no differences in the CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score, although A\u2010CKD patients had a higher bleeding risk according to the HASBLED scale. Global procedural success was 99.1%. At follow\u2010up, there were no differences in stroke rate: at 1\u2010year (HR: 1.22, IC\u201095%: 0.14\u201310.42, <jats:italic>p<\/jats:italic>\u2009=\u20090.861); at 5\u2010years (HR: 0.60, IC\u201095%: 0.08\u20134.58, <jats:italic>p<\/jats:italic>\u2009=\u20090.594). Although bleeding events were higher in the A\u2010CKD group, no differences were found in major bleeding (defined BARC\u2009\u2265\u20093) at 1\u2010year (HR: 1.34, IC\u201095%: 0.63\u20132.88, <jats:italic>p<\/jats:italic>\u2009=\u20090.464) or at 5\u2010years follow\u2010up (HR: 1.30, IC\u201095%: 0.69\u20132.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.434). Mortality rate at 5 years was higher in the A\u2010CKD patients (HR: 1.84, IC\u201095%: 1.18\u20132.87, <jats:italic>p<\/jats:italic>\u2009=\u20090.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LAAO is an effective and safe treatment in A\u2010CKD patients to prevent ischemic events and bleeding. This strategy could be an alternative to oral anticoagulation in this high\u2010risk group of patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30946","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T09:14:48Z","timestamp":1704273288000},"page":"499-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Left atrial appendage occlusion in patients suffering from advanced chronic kidney disease (stage 4 and 5). Long\u2010term follow\u2010up"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6462-4061","authenticated-orcid":false,"given":"Sergio","family":"L\u00f3pez\u2010Tejero","sequence":"first","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0573-4321","authenticated-orcid":false,"given":"Pablo","family":"Ant\u00fanez\u2010Mui\u00f1os","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Fraile\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Nephrology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles Barreira\u2010de","family":"Sousa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Rodr\u00edguez\u2010Collado","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1547-460X","authenticated-orcid":false,"given":"Jes\u00fas","family":"Herrero\u2010Garibi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabi\u00e1n","family":"Blanco\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Diego\u2010Nieto","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo C.","family":"Delgado\u2010Lapeira","sequence":"additional","affiliation":[{"name":"Department of Nephrology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Candelas P\u00e9rez","family":"del Villar\u2010Moro","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mart\u00edn\u2010Moreiras","sequence":"additional","affiliation":[{"name":"Department of Cardiology Complejo asistencial universitario de Salamanca (CAUSA) Salamanca Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca (IBSAL) Salamanca Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBER\u2010CV)  Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro 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