Impact of HAS-BLED Score on outcome after percutaneous left atrial appendage closure: insights from the German Left Atrial Appendage Occluder Registry LAARGE

Ledwoch, Jakob and Franke, Jennifer and Brachmann, Johannes and Lewalter, Thorsten and Akin, Ibrahim and Senges, Jochen and Hochadel, Matthias and Zeymer, Uwe and Weiß, Christian and Krapivsky, Alexander and Sievert, Horst (2021) Impact of HAS-BLED Score on outcome after percutaneous left atrial appendage closure: insights from the German Left Atrial Appendage Occluder Registry LAARGE. Clinical Research in Cardiology. ISSN 1861-0692

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Official URL: https://doi.org/10.1007/s00392-021-01911-1

Abstract

Aim- Percutaneous left atrial appendage (LAA) closure has been established as alternative stroke prophylaxis in patients with non-valvular atrial fibrillation (AF) and high bleeding risk. However, little is known regarding the outcome after LAA closure depending on the HAS-BLED score. Methods- A sub-analysis of the prospective, multicenter, Left-Atrium-Appendage Occluder Register—GErmany (LAARGE) registry was performed assessing three different groups with respect to the HAS-BLED score (0–2 [group 1] vs. 3–4 [group 2] vs. 5–7 [group 3]). Results- A total of 633 patients at 38 centers were enrolled. Of them, 9% (n = 59) were in group 1, 63% (n = 400) in group 2 and 28% (n = 174) in group 3. The Kaplan–Meier estimated 1-year composite of death, stroke and systemic embolism was 3.4% in group 1 vs. 10.4% in group 2 vs. 20.1% in group 3, respectively (p log-rank < 0.001). The difference was driven by death since stroke and systemic embolism did not show a significant difference between the groups. The rate of major bleeding at 1 year was 0% vs. 0% vs. 2.4%, respectively (p = 0.016). Conclusion- The present data show that patients had similarly low rates of ischemic complications 1 year after LAA closure irrespective of the baseline bleeding risk. Higher HAS-BLED scores were associated with increased mortality due to higher age and more severe comorbidity of these patients.

Item Type: Journal Article
Keywords: Left atrial appendage closure, Stroke prevention, Bleeding, HAS-BLED
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 21 Sep 2021 15:54
Last Modified: 21 Sep 2021 15:54
URI: https://arro.anglia.ac.uk/id/eprint/706952

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