{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T17:41:29Z","timestamp":1783964489552,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left atrial appendage occlusion (LAAO) is an alternative to chronic oral anticoagulation (OAT) for stroke prevention in nonvalvular atrial fibrillation (NVAF) patients with contraindications to OAT. Postprocedure antithrombotic therapy (ATT) is essential to reduce the risk of device\u2010related thrombosis (DRT), but the optimal regimen remains uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aims to compare the safety and efficacy of low\u2010dose direct oral anticoagulants (DOACs) versus dual antiplatelet therapy (DAPT) following LAAO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search of PubMed, Scopus, Cochrane, and Web of Science was conducted in August 2024. Studies comparing low\u2010dose DOACs and DAPT post\u2010LAAO were included. The primary outcomes were a composite efficacy endpoint (DRT, strokes, and systemic embolism [SE]) and major bleeding events as the safety endpoint. Secondary outcomes included all bleeding events, all\u2010cause mortality, and a composite of efficacy and safety endpoints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four studies with 727 patients were included. Low\u2010dose DOACs were associated with lower rates of the primary composite efficacy endpoint compared to DAPT (OR\u2009=\u20090.36; 95% CI [0.16, 0.85], <jats:italic>p<\/jats:italic>\u2009=\u20090.01). No significant difference in major bleeding events was observed (OR\u2009=\u20090.36; 95% CI [0.11, 1.18]; <jats:italic>p<\/jats:italic>\u2009=\u20090.091; <jats:italic>I<\/jats:italic>\u00b2\u2009=\u20090%). Compared to DAPT, low\u2010dose DOACs were also associated with lower rates of DRT events (OR\u2009=\u20090.36; 95% CI [0.16, 0.79], <jats:italic>p<\/jats:italic>\u2009=\u20090.011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low\u2010dose DOACs effectively reduce thromboembolic events post\u2010LAAO without increasing bleeding risk. These findings support their use as a viable ATT option, but larger trials are needed to confirm optimal regimens.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31461","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T07:50:45Z","timestamp":1740124245000},"page":"1311-1319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Efficacy and Safety of Low\u2010Dose Direct Oral Anticoagulants Versus Dual Antiplatelet Therapy Following Left Atrial Appendage Occlusion in Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"105","author":[{"given":"Ahmed","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7334-9711","authenticated-orcid":false,"given":"Laila","family":"Shalabi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Gharyan University Gharyan Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2806-8396","authenticated-orcid":false,"given":"Sofian","family":"Zreigh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrouk","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohaila","family":"Mourad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9874-9283","authenticated-orcid":false,"given":"Ghaith","family":"Eljadid","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Beshr","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences Sana'a University Sana'a Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1940-4258","authenticated-orcid":false,"given":"Ali","family":"Abdelaziz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6406-4212","authenticated-orcid":false,"given":"Muhammed","family":"Elhadi","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine Seongbuk\u2010gu Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-3673","authenticated-orcid":false,"given":"Pierre","family":"Sabouret","sequence":"additional","affiliation":[{"name":"National College of French Cardiologists Paris France"},{"name":"ACTION Study Group, Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital Sorbonne University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9241-8890","authenticated-orcid":false,"given":"Mamas","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele Cardiovascular Research Group Keele University Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000140263.20897.42"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2023658"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus305"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.8.983"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.5603\/KP.2016.0172"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0670"},{"key":"e_1_2_12_9_1","first-page":"51","article-title":"Current Issues in Patient Adherence and Persistence: Focus on Anticoagulants for the Treatment and Prevention of Thromboembolism","volume":"4","author":"Kneeland P. 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