"GENDER DISPARITIES IN OUTCOMES OF LEFT ATRIAL APPENDAGE OCCLUSION DEVI" by Manoj Kumar, Shafaqat Ali et al.
 

Abstract

Background

Atrial fibrillation (AF) is the most common cardiac arrhythmia. It is associated with profound morbidity & mortality, including a fivefold increase in stroke risk. Due to side effects & compliance issues associated with anticoagulation, left atrial appendage occlusion (LAAO) devices have emerged as an alternative approach. However, women have been underrepresented in both the PROTECT & PREVAIL trials, landmark trials supporting LAAO use.

Objective

We aim to compare gender disparities in outcomes of LAAO occlusive devices.

Methods

The national readmission database (2016-2020) was utilized to identify hospitalizations for LAAO placement. Cohorts were stratified by gender. A propensity score matching (PSM) model matched males & females. Pearson’s x2 test was applied to PSM-2 matched cohorts to compare outcomes.

Results

Among 89,552 hospitalizations for LAAO placement; 41.3% of procedures were performed in females. Females were found to have a lower prevalence of diabetes, hypertension, hyperlipidemia & chronic kidney disease [p<0.001]. After propensity matching (N=20,627), females were found to have higher adverse events, including mortality (0.23% vs 0.15%,aOR:1.49, p:0.041), sudden cardiac arrest (1.77% vs 1.37%,aOR:1.38, p: 0.001), pericardial complications (1.46% vs 0.86%,aOR:1.65, p<0.001), cardiac tamponade (0.94% vs 0.54%,aOR:1.75, p<0.001), post-procedural bleeding (0.69% vs 0.53%,aOR:1.09, p:0.032) & net adverse events (NAE) (4.73% vs 4.24%,aOR: 1.17, p<0.001). Females also had higher readmission rates at 30-day (9.42% vs 8.07%, p<0.001) & subsequently at 90-day & 180-day intervals (p<0.001). No difference was noted in resource utilization (LOS & cost of hospitalization) between males & females (p>0.05).

Conclusion

In hospitalizations for LAAO device placement, females tend to suffer higher mortality, adverse events & readmission rates as compared to males; although resource utilization is similar.

Document Type

Meeting Abstract

Publication Date

5-2024

Publication Title

Heart Rhythm

First Page

S388

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