Is Left Atrial Appendage Occlusion Always Better than Direct Oral Anticoagulants?

Abstract

https://e-kcj.org Proportion of nonvalvular atrial fibrillation (AF) patients at high risk of stroke patients based on Congestive heart failure, Hypertension, Age≥75, Stroke, Vascular disease, Age 65–74, Vascular disease, female sex (CHA2DS2VASc) score as well as prevalence of AF has been increasing.1) With introduction of direct oral anticoagulants (DOACs), use of oral anticoagulation in nonvalvular AF patients at high risk of stoke has been increased in Korea.2) While multiple large-scale randomized clinical studies demonstrated not only superiority of DOAC over warfarin in terms of intracranial hemorrhage, and major bleeding, but also non-inferiority in terms of ischemic stroke and mortality, a significant number of patients discontinued DOAC due to bleeding.3)