{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:47:40Z","timestamp":1760161660240,"version":"3.40.5"},"reference-count":0,"publisher":"S. Karger AG","issue":"3-4","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2019]]},"abstract":"<b><i>Background:<\/i><\/b> Patients surviving an initial stroke present a significantly increased risk for further strokes. Left atrial appendage closure (LAAC) became an alternative treatment to pharmacological therapy for stroke prevention in atrial fibrillation (AF) patients. <b><i>Objective:<\/i><\/b> To evaluate the long-term efficacy of LAAC in primary and secondary stroke prevention in patients with AF. <b><i>Methods:<\/i><\/b> This retrospective study enrolled 139 patients following LAAC who were divided into 2 groups: 37 patients with prior stroke (Stroke Group) and 102 patients without stroke (Control Group). Overall, cumulative follow-up was 530.1 patient-years. <b><i>Results:<\/i><\/b> Mean CHADS<sub>2<\/sub>, CHA<sub>2<\/sub>DS<sub>2<\/sub>-VASc scores, and HAS-BLED score were higher in patients with prior stroke compared to patients without stroke (3.0 vs. 1.4, <i>p<\/i> &#x3c; 0.0001 and 4.6 vs. 2.3, <i>p<\/i> &#x3c; 0.0001, 4.0 vs. 2.8, <i>p<\/i> &#x3c; 0.0001, respectively). There were no significant differences between other patient factors (sex, heart failure, hypertension, previous stroke\/transient ischemic attack, peripheral vascular disease), which may increase the risk of thromboembolism based on the CHA<sub>2<\/sub>DS<sub>2<\/sub>-VASc score. Average follow-up was 51.3 months in patients with previous stroke and 50 months in patients without previous stroke. Thromboembolic event rate was 0.8 vs. 0.5 (<i>p<\/i> = 0.72), bleeding event rate was 0 years vs. 1.4 (<i>p<\/i> = 0.25), and mortality rates were 0.8 vs. 2.1 (<i>p<\/i> = 0.38) between the Stroke Group and the Control Group. The estimated reductions in thromboembolic and bleeding risks were 89 and 100%, respectively, in Stroke Group, and 91 and 81%, respectively, in Control Group. <b><i>Conclusion:<\/i><\/b> Patients with prior stroke may be the preferred group for LAAC regardless of the presence or absence of contraindications for anticoagulant therapy.<\/jats:p>","DOI":"10.1159\/000500850","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T21:00:46Z","timestamp":1558645246000},"page":"188-195","source":"Crossref","is-referenced-by-count":17,"title":["Left Atrial Appendage Occlusion for Secondary Stroke Prevention in Patients with Atrial Fibrillation: Long-Term Results"],"prefix":"10.1159","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-8987","authenticated-orcid":false,"given":"Radoslaw","family":"Litwinowicz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Bartus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michalina","family":"Malec-Litwinowicz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Michalski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Banaszkiewicz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boguslaw","family":"Kapelak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhanunjaya","family":"Lakkireddy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Bartus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2019,5,23]]},"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/500850","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/500850","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:41:32Z","timestamp":1745426492000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000500850"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":0,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2019,7,3]]},"published-print":{"date-parts":[[2019,7,11]]}},"URL":"https:\/\/doi.org\/10.1159\/000500850","archive":["Portico"],"relation":{},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"type":"print","value":"1015-9770"},{"type":"electronic","value":"1421-9786"}],"subject":[],"published":{"date-parts":[[2019]]}}}