{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:13:24Z","timestamp":1792761204475,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,10,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">This study aimed to compare percutaneous left atrial appendage occlusion (LAAO) with non\u2010vitamin K antagonist oral anticoagulants among patients with atrial fibrillation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using a US administrative database, 562\u2009850 patients with atrial fibrillation were identified, among whom 8397 were treated with LAAO and 554\u2009453 were treated with non\u2010vitamin K antagonist oral anticoagulants between March 13, 2015 and December 31, 2018. Propensity score overlap weighting was used to balance baseline characteristics. The primary outcome was a composite end point of ischemic stroke or systemic embolism, major bleeding, and all\u2010cause mortality. The mean age was 76.4\u00b17.6\u2009years; 280\u2009097 (49.8%) were female. Mean follow\u2010up was 1.5\u00b11.0\u2009years. LAAO was associated with no significant difference in the risk of the primary composite end point (hazard ratio [HR], 0.93 [0.84\u20131.03]), or the secondary outcomes including ischemic stroke\/systemic embolism (HR, 1.07 [0.81\u20131.41]), and intracranial bleeding (HR, 1.08 [0.72\u20131.61]). LAAO was associated with a higher risk of major bleeding (HR, 1.22 [1.05\u20131.42],\n              <jats:italic>P<\/jats:italic>\n              =0.01) and a lower risk of mortality (HR, 0.73 [0.64\u20130.84],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The lower risk of mortality associated with LAAO was most pronounced in patients with a prior history of intracranial bleeding.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In comparison to non\u2010vitamin K antagonist oral anticoagulants, LAAO was associated with no significant difference in the risk of the composite outcome and a lower risk of mortality, which suggests LAAO might be a reasonable option in select patients with atrial fibrillation. The observation of higher bleeding risk associated with LAAO highlights the need to optimize postprocedural antithrombotic regimens as well as systematic efforts to assess and address bleeding predispositions.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.027001","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T09:46:09Z","timestamp":1664444769000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Percutaneous Left Atrial Appendage Occlusion in Comparison to Non\u2010Vitamin K Antagonist Oral Anticoagulant Among Patients With Atrial Fibrillation"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4308-0456","authenticated-orcid":false,"given":"Peter A.","family":"Noseworthy","sequence":"first","affiliation":[{"name":"Robert D. and Patricia E. 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