Sex Differences in the Clinical Outcomes After Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis

Abusnina, Waiel; Latif, Azka; Al‐Abdouh, Ahmad; Mostafa, Mostafa R.; Radaideh, Qais; Alshebani, Yazeid; Aboeata, Ahmad; Ben‐Dor, Itsik; Michos, Erin D.; Dahal, Khagendra

doi:10.1016/j.carrev.2021.12.013

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…However, both of their studies performed 2‐year follow‐up and showed that the annual rates of thromboembolic events were comparable in women and men and were significantly decreased in women when compared with preprocedural risk predicted by the CHA 2 DS 2‐ VASc score. Recently, Abushnina et al 17 performed a meta‐analysis of 5 studies reporting sex differences in outcomes after LAAO, but the study by Osman et al with the second‐largest sample size was excluded.…”

Section: Discussionmentioning

confidence: 99%

“…However, both of their studies performed 2-year follow-up and showed that the annual rates of thromboembolic events were comparable in women and men and were significantly decreased in women when compared with preprocedural risk predicted by the CHA 2 DS 2-VASc score. Recently, Abushnina et al 17 Several plausible explanations exist for the increased risk of procedure-related complications in women. Women hospitalized with AF were usually older and more likely to present with comorbidities of hypertension, diabetes mellitus, and renal insufficiency.…”

Section: Discussionmentioning

confidence: 99%

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Sex differences on outcomes following left atrial appendage occlusion in atrial fibrillation: A systematic review and meta‐analysis

Zhu

Sasmita

Xue

et al. 2022

Cathet Cardio Intervent

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There is a lack of sufficient data on sex‐related differences in outcomes of nonvalvular atrial fibrillation (AF) patients following left atrial appendage occlusion (LAAO). We conducted a meta‐analysis to investigate the procedural complications and long‐term outcomes after LAAO in women versus men. We screened Medline, EMBASE, Cochrane Center Register of Controlled Trials, and Clinical http://Trials.gov. The inclusion criteria were studies targeting the sex‐related differences in outcomes in nonvalvular AF patients treated by LAAO. Procedural endpoints of interest included success rate, pericardial complications, major bleeding, and vascular complications during hospitalization. Long‐term outcomes included all‐cause mortality and ischemic stroke during follow‐up. Studies that merely considered sex in the subgroup analysis were not included. Six observational studies with a total of 64,035 patients were identified. The procedural success rates did not differ between sexes (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.89–1.09, p = 0.77), while women experienced more pericardial complications (OR: 1.78, 95% CI: 1.58–2.01, p < 0.00001), major bleedings (OR: 2.04, 95% CI: 1.75–2.39, p < 0.00001), and vascular complications (OR: 1.75, 95% CI: 1.41–2.17, p < 0.00001) than men. The sensitivity analysis performed by removing the largest study showed good stability. The long‐term mortality and stroke rates did not differ between women and men in either the 1‐year subgroup or the 2‐year subgroup. In conclusion, despite comparable procedural success rates, women have a significantly higher incidence of pericardial complications, major bleeding, and vascular complications following LAAO. The long‐term mortality and stroke rates do not differ between the sexes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sex differences on outcomes following left atrial appendage occlusion in atrial fibrillation: A systematic review and meta‐analysis

Zhu

Sasmita

Xue

et al. 2022

Cathet Cardio Intervent

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“…Catheter ablation of AF 45 Left atrial appendage closure 46,47 Association with stroke risk Hypertension [29][30][31] Diabetes mellitus 29,37 Atrial fibrillation (AF) 39,40 Migraine 63 Smoking 29,69…”

Section: Diabetes Mellitusmentioning

confidence: 99%

“…45 Recent studies have also shown that women are more likely to experience worse periprocedural outcomes after left atrial appendage closure. 46,47…”

Section: Atrial Fibrillationmentioning

confidence: 99%

“…Furthermore, women who underwent catheter ablation of AF experience lower efficacy and a higher risk of stroke/TIA and major complications than men [ 45 ]. Recent studies have also shown that women are more likely to experience worse periprocedural outcomes after left atrial appendage closure [ 46 , 47 ].…”

Section: Risk Factors ( Figure 1 )mentioning

confidence: 99%

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Stroke in Women: A Review Focused on Epidemiology, Risk Factors, and Outcomes

Yoon

Bushnell

2023

J Stroke

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Stroke is a particularly important issue for women. Women account for over half of all persons who experienced a stroke. The lifetime risk of stroke is higher in women than in men. In addition, women have worse stroke outcomes than men. Several risk factors have a higher association with stroke in women than in men, and women-specific risk factors that men do not have should be considered. This focused review highlights recent findings in stroke epidemiology, risk factors, and outcomes in women.

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Sex differences in stroke

McCullough,

Sprenger-Svačina

2025

Sex and Gender Differences in Cardiovascular-Renal-Metabolic Physiology and Pathophysiology

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Sex Differences in the Clinical Outcomes After Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis

Cited by 10 publications

References 20 publications

Sex differences on outcomes following left atrial appendage occlusion in atrial fibrillation: A systematic review and meta‐analysis

Sex differences on outcomes following left atrial appendage occlusion in atrial fibrillation: A systematic review and meta‐analysis

Stroke in Women: A Review Focused on Epidemiology, Risk Factors, and Outcomes

Sex differences in stroke

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