Chronic kidney disease (CKD) is associated with an increased risk for bleeding events and in-hospital mortality in patients receiving left atrial appendage occlusion (LAAO) device implantation, according to research presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 held from September 17th through 19th, in Boston, Massachusetts.
Researchers conducted a systematic review and meta-analysis of studies comparing outcomes among patients with and without CKD who received LAAO device implantation. They searched PubMed and Google Scholar databases for relevant studies and analyzed outcome data with use of a random effects model.
A total of 11 studies with 78,257 patients were included in the final analysis. No difference was found regarding the risk for ischemic transient event or stroke (odds ratio [OR], 1.24; 95% CI, 0.87-1.77; P =.23) during the follow-up. Patients with CKD had an increased risk for bleeding (OR, 1.55; 95% CI, 1.41-1.70; P <.01) and in-hospital mortality (OR, 1.63; 95% CI, 1.11-2.40; P =.01) with LAAO device implantation.
No difference was observed for risk for significant pericardial effusion (OR, 1.17; 95% CI, 0.86-1.57; P =.32), vascular complications (OR, 1.18; 95% CI, 0.92-1.51; P =.18), or device-related thrombus (OR, 1.13; 95% CI, 0.53-2.40; P =.75) between the 2 groups.
“Due to a delicate balance between increased risks of thrombotic and bleeding events in this population, future studies comparing outcomes with LAAO and anticoagulation are warranted in CKD patients,” the study authors wrote.
Gill GS, Shailly S, Ponna PK, Kanmanthareddy A, Alla VM. Stroke and safety outcomes with left atrial appendage occlusion device implantation in chronic kidney disease: a systematic review and meta-analysis. Presented at: The Transcatheter Cardiovascular Therapeutics Scientific Symposium; September 17-19, 2022; Boston, MA. Abstract #546.