Association between rates of ischemic stroke and all-cause mortality with the Watchman device compared to warfarin and direct oral anticoagulants in patients with atrial fibrillation

Etumuse, Bright; Miles, Brittany

doi:10.1080/08998280.2023.2269354

Baylor University Medical Center Proceedings

2023

DOI: 10.1080/08998280.2023.2269354

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Association between rates of ischemic stroke and all-cause mortality with the Watchman device compared to warfarin and direct oral anticoagulants in patients with atrial fibrillation

Bright Etumuse,

Brittany Miles

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Cited by 2 publications

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Epistaxis Risk in Patients Treated With Left Atrial Appendage Occlusion Versus Oral Anticoagulation

Mandloi,

Nunes,

Sina

et al. 2024

The Laryngoscope

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IntroductionAnticoagulants (AC) are associated with epistaxis in atrial fibrillation (AF) patients. Left atrial appendage occlusion (LAAO) is a treatment that allows AF patients to stop AC. The aim of this study is to evaluate the risk of developing epistaxis following LAAO versus direct oral anticoagulants (DOAC) and warfarin.MethodsThis study uses the TriNetX database as well as institutional records. The TriNetX database was searched for AF patients on a DOAC, warfarin, or treated with LAAO. Epistaxis odds ratios were compared 1 day–6 months and 6 months–3 years following initiation of DOAC, warfarin, or LAAO. Records of LAAO patients at our institution were also reviewed.ResultsThe TriNetX query returned 1,185,862 patients. On TriNetX, LAAO patients had significantly higher odds of epistaxis likely due to antiplatelet therapy from 1 day–6 months compared to warfarin patients with DOAC patients (p < 0.0001). From 6 months–3 years after treatment initiation, LAAO patients experience reduced odds of epistaxis and epistaxis requiring nasal packing compared to warfarin patients (OR: 0.69 p = 0.0003; OR: 0.58 p = 0.0043). Institutionally, epistaxis resolved in 66% (8/12) LAAO patients with a history of epistaxis with an average follow‐up of 1.5 years.DiscussionLAAO decreased the frequency of epistaxis and epistaxis requiring nasal packing in AF patients on warfarin after 6 months. Our institutional experience demonstrates long‐term improvement in epistaxis after LAAO for DOAC and warfarin patients. Additional studies need to be performed to account for dual antiplatelet following LAAO on epistaxis risk.Level of EvidenceLevel 3 Laryngoscope, 2024

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Epistaxis Risk in Patients Treated With Left Atrial Appendage Occlusion Versus Oral Anticoagulation

Mandloi,

Nunes,

Sina

et al. 2024

The Laryngoscope

View full text Add to dashboard Cite

show abstract

Left atrial appendage exclusion, here to stay

Banchs

2023

Baylor University Medical Center Proceedings

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Association between rates of ischemic stroke and all-cause mortality with the Watchman device compared to warfarin and direct oral anticoagulants in patients with atrial fibrillation

Cited by 2 publications

References 17 publications

Epistaxis Risk in Patients Treated With Left Atrial Appendage Occlusion Versus Oral Anticoagulation

Epistaxis Risk in Patients Treated With Left Atrial Appendage Occlusion Versus Oral Anticoagulation

Left atrial appendage exclusion, here to stay

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