Peri-Procedural Outcomes of Left Atrial Appendage Occlusion in Lower Versus Higher CHA2DS2-VASc Score

Percutaneous left atrial appendage occlusion (LAAO) is used to prevent stroke in atrial fibrillation. We present a national registry analysis of peri-procedural outcomes of LAAO among patients with lower versus higher CHA(2)DS(2)-VASc score. The National Readmissions Database was used to perform a retrospective review of all hospitalizations for percutaneous endocardial LAAO identified between September 2015 and November 2019. ICD codes for congestive heart failure, hypertension, type 2 diabetes, stroke, transient ischemic attack, thromboembolism, and vascular disease were identified. CHA(2)DS(2)-VASc was calculated. Lower CHA(2)DS(2)-VASc score was defined as <5 and higher score as >= 5. Propensity matched (PSM) analysis at index hospitalization and 30 days was used to compare a matched sample of patients undergoing LAAO with lower and higher CHA(2)DS(2)-VASc. Outcomes examined included all-cause mortality, stroke, major bleeding, pericardial effusion, and cardiac tamponade. A sample of patients who underwent LAAO with lower CHA(2)DS(2)-VASc (n = 40,879) and higher CHA(2)DS(2)-VASc (n = 14,438) was identified for crude analysis. From this cohort, a sample of patients with lower CHA(2)DS(2)-VASc (n = 14,219) and higher CHA(2)DS(2)-VASc (n = 14,388) was selected for PSM analysis. Both crude and PSM analyses at index hospitalization found higher odds of mortality in the higher CHA(2)DS(2)-VASc group but no significant difference in odds of major bleeding, stroke, pericardial effusion, or cardiac tamponade. Our findings showed associated a higher CHA(2)DS(2)-VASc score with a higher risk of mortality without an increased risk of common complications peri-procedurally. In conclusion, findings display the overall safety of LAAO for patients with both lower and higher CHA(2)DS(2)-VASc score. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.