Abstract
Background: Left atrial appendage closure is a non-pharmacological alternative for stroke prevention in high-risk non-valvular atrial fibrillation patients, but has not been widely studied in Asian patients. The prospective WASP registry assessed real-world outcomes for patients undergoing WATCHMAN implant in the Asia-Pacific region. Methods: Data were collected from consecutive patients across 9 centres. Major endpoints included procedural success, safety and long-term outcomes including occurrence of bleeding, stroke/transient ischaemic attack/systemic embolism and all-cause mortality. Results: Subjects (n = 201) had a mean age of 70.8 ± 9.4 years, high stroke risk (CHA 2 DS 2 -VASc: 3.9 ± 1.7), elevated bleeding risk (HAS-BLED: 2.1 ± 1.2) with 53% patients from Asian countries. Successful implantation occurred in 98.5% of patients; 7-day device/procedure-related SAE rate was 3.0%. After 2 years of follow-up, the rates of ischaemic stroke/TIA/SE and major bleeding were 1.9 and 2.2 per 100-PY, respectively, representing relative reductions of 77% and 49% versus expected rates per risk scores. The relative risk reductions versus expected rates were more pronounced in Asians vs. Non-Asians (89% vs 62%; 77% vs 14%). Other significant findings included larger mean LAA ostium diameter for Asians vs. Non-Asians (23.4 ± 4.1 mm vs. 21.2 ± 3.2 mm, p < 0.001) and hence requirement for larger median device size (27 mm for Asians, 24 mm for non-Asians [p < 0.0001]). Conclusion: Real-world experience of left atrial appendage closure with WATCHMAN has demonstrated low peri-procedural risk, and long-term efficacy for stroke and bleeding prevention in a primarily Asian cohort.
| Original language | English |
|---|---|
| Article number | 100358 |
| Journal | IJC Heart and Vasculature |
| Volume | 23 |
| DOIs | |
| Publication status | Published - 2019 Jun |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Left atrial appendage closure with WATCHMAN in Asian patients : 2 year outcomes from the WASP registry. / Phillips, Karen P.; Santoso, Teguh; Sanders, Prashanthan; Alison, Jeffrey; Chan, Jason Leung Kwai; Pak, Hui Nam; Chandavimol, Mann; Stein, Kenneth M.; Gordon, Nicole; Razali, Omar Bin.
In: IJC Heart and Vasculature, Vol. 23, 100358, 06.2019.Research output: Contribution to journal › Article
TY - JOUR
T1 - Left atrial appendage closure with WATCHMAN in Asian patients
T2 - 2 year outcomes from the WASP registry
AU - Phillips, Karen P.
AU - Santoso, Teguh
AU - Sanders, Prashanthan
AU - Alison, Jeffrey
AU - Chan, Jason Leung Kwai
AU - Pak, Hui Nam
AU - Chandavimol, Mann
AU - Stein, Kenneth M.
AU - Gordon, Nicole
AU - Razali, Omar Bin
PY - 2019/6
Y1 - 2019/6
N2 - Background: Left atrial appendage closure is a non-pharmacological alternative for stroke prevention in high-risk non-valvular atrial fibrillation patients, but has not been widely studied in Asian patients. The prospective WASP registry assessed real-world outcomes for patients undergoing WATCHMAN implant in the Asia-Pacific region. Methods: Data were collected from consecutive patients across 9 centres. Major endpoints included procedural success, safety and long-term outcomes including occurrence of bleeding, stroke/transient ischaemic attack/systemic embolism and all-cause mortality. Results: Subjects (n = 201) had a mean age of 70.8 ± 9.4 years, high stroke risk (CHA 2 DS 2 -VASc: 3.9 ± 1.7), elevated bleeding risk (HAS-BLED: 2.1 ± 1.2) with 53% patients from Asian countries. Successful implantation occurred in 98.5% of patients; 7-day device/procedure-related SAE rate was 3.0%. After 2 years of follow-up, the rates of ischaemic stroke/TIA/SE and major bleeding were 1.9 and 2.2 per 100-PY, respectively, representing relative reductions of 77% and 49% versus expected rates per risk scores. The relative risk reductions versus expected rates were more pronounced in Asians vs. Non-Asians (89% vs 62%; 77% vs 14%). Other significant findings included larger mean LAA ostium diameter for Asians vs. Non-Asians (23.4 ± 4.1 mm vs. 21.2 ± 3.2 mm, p < 0.001) and hence requirement for larger median device size (27 mm for Asians, 24 mm for non-Asians [p < 0.0001]). Conclusion: Real-world experience of left atrial appendage closure with WATCHMAN has demonstrated low peri-procedural risk, and long-term efficacy for stroke and bleeding prevention in a primarily Asian cohort.
AB - Background: Left atrial appendage closure is a non-pharmacological alternative for stroke prevention in high-risk non-valvular atrial fibrillation patients, but has not been widely studied in Asian patients. The prospective WASP registry assessed real-world outcomes for patients undergoing WATCHMAN implant in the Asia-Pacific region. Methods: Data were collected from consecutive patients across 9 centres. Major endpoints included procedural success, safety and long-term outcomes including occurrence of bleeding, stroke/transient ischaemic attack/systemic embolism and all-cause mortality. Results: Subjects (n = 201) had a mean age of 70.8 ± 9.4 years, high stroke risk (CHA 2 DS 2 -VASc: 3.9 ± 1.7), elevated bleeding risk (HAS-BLED: 2.1 ± 1.2) with 53% patients from Asian countries. Successful implantation occurred in 98.5% of patients; 7-day device/procedure-related SAE rate was 3.0%. After 2 years of follow-up, the rates of ischaemic stroke/TIA/SE and major bleeding were 1.9 and 2.2 per 100-PY, respectively, representing relative reductions of 77% and 49% versus expected rates per risk scores. The relative risk reductions versus expected rates were more pronounced in Asians vs. Non-Asians (89% vs 62%; 77% vs 14%). Other significant findings included larger mean LAA ostium diameter for Asians vs. Non-Asians (23.4 ± 4.1 mm vs. 21.2 ± 3.2 mm, p < 0.001) and hence requirement for larger median device size (27 mm for Asians, 24 mm for non-Asians [p < 0.0001]). Conclusion: Real-world experience of left atrial appendage closure with WATCHMAN has demonstrated low peri-procedural risk, and long-term efficacy for stroke and bleeding prevention in a primarily Asian cohort.
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U2 - 10.1016/j.ijcha.2019.100358
DO - 10.1016/j.ijcha.2019.100358
M3 - Article
AN - SCOPUS:85063957085
VL - 23
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
SN - 2352-9067
M1 - 100358
ER -