{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:17:45Z","timestamp":1783469865649,"version":"3.55.0"},"reference-count":27,"publisher":"IMR Press","issue":"2","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: Prevention of stroke by anticoagulation is essential in patients with Atrial fibrillation (AF); with direct oral anticoagulants (DOACs) being preferred over warfarin in most patients. The Long-term efficacy and safety of DOACs vs. Left Atrial Appendage Occlusion (LAAO) remain unknown. Methods: Electronic databases (PubMed, Embase, Scopus) were searched from inception to February 10th, 2021. The primary endpoint was cardiovascular mortality. Secondary outcomes included incidence of ischemic stroke\/transient ischemic attack (TIA) and systemicembolism. The safety endpoint was clinically relevant bleeding (a composite of major or minor clinically relevant bleeding). Results: A total of three studies with 3039 participants (LAAO = 1465; DOACs = 1574) were included. Mean age was 74.2 and 75.3 years in the LAAO and DOAC group respectively. Average follow-up period was 2 years. There was no difference in terms of cardiac mortality (RR 0.90, 95% CI 0.40\u20132.03; p = 0.81), ischemic stroke\/TIA (RR 1.15, 95% CI 0.80\u20131.65; p = 0.46; I2 = 0) and clinically significant bleeding (RR 0.77, 95% CI 0.50\u20131.17; p = 0.22; I2 = 69) between the groups. Conclusions: Among patients with AF, LAAO was comparable to DOACs with similar efficacy and safety profiles.<\/jats:p>","DOI":"10.31083\/j.rcm2402044","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T09:05:31Z","timestamp":1675328731000},"source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Efficacy and Safety of Left Atrial Appendage Occlusion (LAAO) vs Direct Oral Anticoagulation (DOAC) in Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis"],"prefix":"10.31083","volume":"24","author":[{"given":"Aminah Abdul","family":"Razzack","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dr. N.T.R University of Health Sciences, 520008 Vijayawada, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan Mehmood","family":"Lak","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greeshma","family":"Erasani","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dr. N.T.R University of Health Sciences, 520008 Vijayawada, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajedur","family":"Rahman","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Jalalabad Ragib Rabeya Medical College and Hospital, 3030 Sylhet, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeel","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Medicine, Saba University School of Medicine, JQG3+87 The Bottom, Netherland Antilles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal Farhat","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Medicine, Akhtar Saeed Medical and Dental College, 54000 Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srilatha","family":"Eapi","sequence":"first","affiliation":[{"name":"Department of Medicine, Hackensack University Medical Center, Hackensack, NJ 07601, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Yasmin","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dow University of Health Sciences, 74200 Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Najeeb","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dow University of Health Sciences, 74200 Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Mustafa","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY 10305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanchit","family":"Chawla","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Bilal","family":"Munir","sequence":"first","affiliation":[{"name":"Section of Electrophysiology, Department of Cardiovascular Medicine, University of. California San Diego, San Diego, CA 92111, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr F","family":"Barakat","sequence":"first","affiliation":[{"name":"Section of Electrophysiology, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA 15260, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Saliba","sequence":"first","affiliation":[{"name":"Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oussama","family":"Wazni","sequence":"first","affiliation":[{"name":"Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman A.","family":"Hussein","sequence":"first","affiliation":[{"name":"Section of Cardiac Pacing and Electrophysiology, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Thrall G, Lane D, Carroll D, Lip GYH. 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