Percutaneous Left Atrial Appendage Closure vs Warfarin for Atrial Fibrillation: A Randomized Clinical Trial
Abstract
IMPORTANCE: While effective in preventing stroke in patients with atrial fibrillation (AF), warfarin is limited by a narrow therapeutic profile, a need for lifelong coagulation monitoring, and multiple drug and diet interactions. OBJECTIVE: To determine whether a local strategy of mechanical left atrial appendage (LAA) closure was noninferior to warfarin. DESIGN, SETTING, AND PARTICIPANTS: PROTECT AF was a multicenter, randomized (2:1), unblinded, Bayesian-designed study conducted at 59 hospitals of 707 patients with nonvalvular AF and at least 1 additional stroke risk factor (CHADS2 score ≥1). Enrollment occurred between February 2005 and June 2008 and included 4-year follow-up through October 2012. Noninferiority required a posterior probability greater than 97.5% and superiority a probability of 95% or greater; the noninferiority margin was a rate ratio of 2.0 comparing event rates between treatment groups. INTERVENTIONS: Left atrial appendage closure with the device (n = 463) or warfarin (n = 244; target international normalized ratio, 2-3). MAIN OUTCOMES AND MEASURES: A composite efficacy end point including stroke, systemic embolism, and cardiovascular/unexplained death, analyzed by intention-to-treat. RESULTS: At a mean (SD) follow-up of 3.8 (1.7) years (2621 patient-years), there were 39 events among 463 patients (8.4%) in the device group for a primary event rate of 2.3 events per 100 patient-years, compared with 34 events among 244 patients (13.9%) for a primary event rate of 3.8 events per 100 patient-years with warfarin (rate ratio, 0.60; 95% credible interval, 0.41-1.05), meeting prespecified criteria for both noninferiority (posterior probability, >99.9%) and superiority (posterior probability, 96.0%). Patients in the device group demonstrated lower rates of both cardiovascular mortality (1.0 events per 100 patient-years for the device group [17/463 patients, 3.7%] vs 2.4 events per 100 patient-years with warfarin [22/244 patients, 9.0%]; hazard ratio [HR], 0.40; 95% CI, 0.21-0.75; P = .005) and all-cause mortality (3.2 events per 100 patient-years for the device group [57/466 patients, 12.3%] vs 4.8 events per 100 patient-years with warfarin [44/244 patients, 18.0%]; HR, 0.66; 95% CI, 0.45-0.98; P = .04). CONCLUSIONS AND RELEVANCE: After 3.8 years of follow-up among patients with nonvalvular AF at elevated risk for stroke, percutaneous LAA closure met criteria for both noninferiority and superiority, compared with warfarin, for preventing the combined outcome of stroke, systemic embolism, and cardiovascular death, as well as superiority for cardiovascular and all-cause mortality. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00129545.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
LAA occlusion was non-inferior to VKA treatment for the prevention of stroke in AF patients with moderate stroke risk, with a possibility of lower bleeding rates in patients who continued follow-up.
“In these data sets, LAA occlusion was non-inferior to VKA treatment for the prevention of stroke in AF patients with moderate stroke risk, with a possibility of lower bleeding rates in the patients who continued follow-up. 452,453”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [452]
Cites
Gelman, A., Carlin, J. B., Stern, H. S., Dunson, D. B., Vehtari, A., & Rubin, D. B. (2013) · doi:10.1201/b16018 · Cited by 27,276 · see citing works
Dabigatran versus warfarin in patients with atrial fibrillation
Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Eikelboom, J., Oldgren, J., Parekh, A., Pogue, J., Reilly, P. A., Themeles, E., Varrone, J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0905561 · Cited by 11,215 · see citing works
Rivaroxaban versus warfarin in nonvalvular atrial fibrillation
Patel, M. R., Mahaffey, K. W., Garg, J., Pan, G., Singer, D. E., Hacke, W., Breithardt, G., Halperin, J. L., Hankey, G. J., Piccini, J. P., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1009638 · Cited by 9,430 · see citing works
Self-citationHart, R. G., Pearce, L. A., & Aguilar, M. I. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-12-200706190-00007 · Cited by 4,793 · cited 2× · see citing works
“Carl Jacobs (Piedmont Hospital, Atlanta [2]); Rajesh Dave (Harrisburg Hospital, Harrisburg, Pennsylvania [1]); John Young (Lindner Clinical Trial Center, Cincinnati, Ohio [1]); David Lasorda (Allegheny General Hospital, Pittsburgh [1]).”
BackgroundApixaban in patients with atrial fibrillation
Connolly, S. J., Eikelboom, J., Joyner, C., Diener, H.-C., Hart, R., Golitsyn, S., Flaker, G., Avezum, A., Hohnloser, S. H., Diaz, R., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1007432 · Cited by 2,483 · see citing works
Holmes, D. R., Reddy, V. Y., Turi, Z. G., Doshi, S. K., Sievert, H., Buchbinder, M., Mullin, C. M., & Sick, P. B. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61343-x · Cited by 2,242 · see citing works
Self-citationEffect of clopidogrel added to aspirin in patients with atrial fibrillation
The ACTIVE Investigators (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0901301 · Cited by 2,102 · see citing works
A Method to Determine the Optimal Intensity of Oral Anticoagulant Therapy
Rosendaal, F. R., Cannegieter, S. C., van der Meer, F. J. M., & Briët, E. (1993) · Thrombosis and Haemostasis · doi:10.1055/s-0038-1651587 · Cited by 2,070 · see citing works
Calkins, H. G., Brugada, J., Packer, D. L., Cappato, R., Chen, S., Crijns, H. J. G. M., Damiano, R. J., Davies, D. W., Haines, D. E., Haı̈ssaguerre, M., et al. (2007) · Heart Rhythm · doi:10.1016/j.hrthm.2007.04.005 · Cited by 1,690 · see citing works
Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation
Blackshear, J. L., & Odell, J. A. (1996) · The Annals of Thoracic Surgery · doi:10.1016/0003-4975(95)00887-x · Cited by 1,686 · cited 3× · see citing works
“Turi (Cooper Hospital, Camden, New Jersey [4]); Bryan Raybuck (INOVA Research Center, Falls Church, Virginia [3]); Ron Waksman, Horst Sievert (Washington Hospital Center, Washington, DC [4]); Steven Kalbfleisch (Ohio State University, Columbus [3]); Michael Mooney (Abbott Northwestern Hospital, Minneapolis [3]); Willi…”
BackgroundCalkins, H. G., Brugada, J., Packer, D. L., Cappato, R., Chen, S.-A., Crijns, H. J. G. M., Damiano, R. J., Davies, D. W., Haines, D. E., Haïssaguerre, M., et al. (2007) · EP Europace · doi:10.1093/europace/eum120 · Cited by 1,289 · see citing works
Safety of Percutaneous Left Atrial Appendage Closure
Reddy, V. Y., Holmes, D. R., Doshi, S. K., Neužil, P., & Kar, S. (2011) · Circulation · doi:10.1161/circulationaha.110.976449 · Cited by 863 · see citing works
Self-citationReddy, V. Y., Möbius-Winkler, S., Miller, M. A., Neuzil, P., Schuler, G., Wiebe, J., Sick, P., & Sievert, H. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.03.035 · Cited by 727 · see citing works
Self-citationReddy, V. Y., Doshi, S. K., Sievert, H., Buchbinder, M., Neužil, P., Huber, K., Halperin, J. L., & Holmes, D. R. (2013) · Circulation · doi:10.1161/circulationaha.112.114389 · Cited by 677 · see citing works
Self-citationWhy Do Patients With Atrial Fibrillation Not Receive Warfarin?
Bungard, T. J., Ghali, W. A., Teo, K. K., McAlister, F. A., & Tsuyuki, R. T. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.1.41 · Cited by 593 · see citing works
Stoddard, M. F., Dawkins, P. R., Prince, C. R., & Ammash, N. M. (1995) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(94)00396-8 · Cited by 531 · see citing works
Sievert, H., Lesh, M. D., Trepels, T., Omran, H., Bartorelli, A. L., Bella, P. D., Nakai, T., Reisman, M., Mario, C. D., Block, P. C., et al. (2002) · Circulation · doi:10.1161/01.cir.0000015698.54752.6d · Cited by 431 · see citing works
Self-citationPark, J., Bethencourt, A., Sievert, H., Santoro, G., Meier, B., Walsh, K. P., Lopez-Minquez, J. R., Meerkin, D., Valdés, M., Ormerod, O. J., et al. (2010) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.22764 · Cited by 422 · see citing works
Self-citationSick, P. B., Schuler, G. C., Hauptmann, K. E., Grube, E., Yakubov, S. J., Turi, Z. G., Mishkel, G. J., ALMANY, S. L., & Holmes, D. R. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.02.035 · Cited by 351 · see citing works
Self-citationNational Trends in Oral Anticoagulant Use in the United States, 2007 to 2011
Kirley, K., Qato, D. M., Kornfield, R., Stafford, R. S., & Alexander, G. C. (2012) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.112.967299 · Cited by 310 · see citing works
Use and Effectiveness of Warfarin in Medicare Beneficiaries With Atrial Fibrillation
Birman-Deych, E., Radford, M. J., Nilasena, D. S., & Gage, B. F. (2006) · Stroke · doi:10.1161/01.str.0000208294.46968.a4 · Cited by 301 · see citing works
Fountain, R. B., Holmes, D. R., Chandrasekaran, K., Packer, D. L., Asirvatham, S. J., Tassel, R. A. V., & Turi, Z. G. (2006) · American Heart Journal · doi:10.1016/j.ahj.2006.02.005 · Cited by 233 · see citing works
Self-citationÅberg, H. E. (1969) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1969.tb07351.x · Cited by 226 · see citing works
Gangireddy, S. R., Halperin, J. L., Fuster, V., & Reddy, V. Y. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs292 · Cited by 83 · see citing works
Self-citationThe effect of anticoagulants on cancer risk and survival: Systematic review
Tagalakis, V., Blostein, M. D., Robinson‐Cohen, C., & Kahn, S. R. (2007) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2007.02.004 · Cited by 55 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P. F., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castellà, M., Diener, H., Heidbüchel, H., Hendriks, J., et al. (2016) · EP Europace · doi:10.1093/europace/euw295 · Cited by 6,438 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., et al. (2021) · Stroke · doi:10.1161/str.0000000000000375 · Cited by 3,237 · see citing works
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A. M., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001193 · Cited by 2,989 · see citing works
January, C. T., Wann, L. S., Calkins, H., Chen, L. Y., Cigarroa, J. E., Cleveland, J. C., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., Furie, K. L., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000665 · Cited by 2,744 · see citing works
January, C. T., Wann, L. S., Calkins, H. G., Chen, L. Y., Cigarroa, J. E., Cleveland, J. C., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., Furie, K. L., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.01.011 · Cited by 2,237 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
5-Year Outcomes After Left Atrial Appendage Closure
Reddy, V. Y., Doshi, S. K., Kar, S., Gibson, D. N., Price, M. J., Huber, K., Horton, R., Buchbinder, M., Neužil, P., Gordon, N. T., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.10.021 · Cited by 1,039 · see citing works
Self-citationAntithrombotic Therapy for Atrial Fibrillation
Lip, G. Y. H., Banerjee, A., Boriani, G., Chiang, C. E., Fargo, R. A., Freedman, B., Lane, D. A., Ruff, C. T., Turakhia, M. P., Werring, D. J., et al. (2018) · CHEST Journal · doi:10.1016/j.chest.2018.07.040 · Cited by 952 · see citing works
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933 · see citing works
Tzikas, A., Shakir, S., Gafoor, S. A., Omran, H., Berti, S. L., Santoro, G., Kefer, J., Landmesser, U., Nielsen‐Kudsk, J. E., Cruz‐González, I., et al. (2016) · EuroIntervention · doi:10.4244/eijy15m01_06 · Cited by 545 · see citing works
Self-citationHolmes, D. R., Doshi, S. K., Kar, S., Price, M. J., Sanchez, J. M., Sievert, H., Valderrabano, M., & Reddy, V. Y. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.04.025 · Cited by 543 · see citing works
Self-citationBoersma, L. V. A., Schmidt, B., Betts, T. R., Sievert, H., Tamburino, C., Teíger, E., Pokushalov, E., Kische, S., Schmitz, T., Steín, K. M., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehv730 · Cited by 522 · see citing works
Self-citationDevice-Related Thrombus After Left Atrial Appendage Closure
Dukkipati, S. R., Kar, S., Holmes, D. R., Doshi, S. K., Swarup, V., Gibson, D. N., Maini, B. S., Gordon, N. T., Main, M. L., & Reddy, V. Y. (2018) · Circulation · doi:10.1161/circulationaha.118.035090 · Cited by 455 · see citing works
Self-citationBoersma, L. V. A., Ince, H., Kische, S., Pokushalov, E., Schmitz, T., Schmidt, B., Gori, T., Meincke, F., Protopopov, A. V., Betts, T. R., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.05.038 · Cited by 433 · see citing works
Self-citationKamel, H., & Healey, J. S. (2017) · Circulation Research · doi:10.1161/circresaha.116.308407 · Cited by 435 · see citing works
The NCDR Left Atrial Appendage Occlusion Registry
Freeman, J. V., Varosy, P. D., Price, M. J., Slotwiner, D. J., Kusumoto, F. M., Rammohan, C., Kavinsky, C. J., Turi, Z. G., Akar, J. G., Koutras, C., et al. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.12.040 · Cited by 421 · see citing works
Postoperative atrial fibrillation following cardiac surgery: a persistent complication
Greenberg, J. W., Lancaster, T. S., Schuessler, R. B., & Melby, S. J. (2017) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezx039 · Cited by 432 · see citing works
Smith, E. E., Saposnik, G., Biessels, G. J., Doubal, F. N., Fornage, M., Gorelick, P. B., Greenberg, S. M., Higashida, R. T., Kasner, S. E., & Seshadri, S. (2017) · Stroke · doi:10.1161/str.0000000000000116 · Cited by 404 · see citing works
January, C. T., Wann, L. S., Calkins, H. G., Chen, L. Y., Cigarroa, J. E., Cleveland, J. C., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., Furie, K. L., et al. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2019.01.024 · Cited by 409 · see citing works
EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update
Glikson, M., Wolff, R., Hindricks, G., Mandrola, J. M., Camm, A. J., Lip, G. Y. H., Fauchier, L., Betts, T. R., Lewalter, T., Saw, J., et al. (2020) · EuroIntervention · doi:10.4244/eijy19m08_01 · Cited by 366 · see citing works
Self-citationBertog, S. C., Sievert, K., Grunwald, I. Q., Sharma, A. N., Hornung, M., Kühn, A. L., Vaškelytė, L., Hofmann, I., Gafoor, S. A., Reinartz, M., et al. (2022) · Interventional Cardiology · doi:10.1002/9781119697367.ch71 · Cited by 356 · see citing works
Self-citationDevice-Related Thrombosis After Percutaneous Left Atrial Appendage Occlusion for Atrial Fibrillation
Fauchier, L., Cinaud, A., Brigadeau, F., Lepillier, A., Pierre, B., Abbey, S., Fatemi, M., Franceschi, F., Guedeney, P., Jacon, P., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.01.076 · Cited by 353 · see citing works
EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion – an update
Glikson, M., Wolff, R., Hindricks, G., Mandrola, J. M., Camm, A. J., Lip, G. Y. H., Fauchier, L., Betts, T. R., Lewalter, T., Saw, J., et al. (2019) · EP Europace · doi:10.1093/europace/euz258 · Cited by 332 · see citing works
Self-citationBrieger, D. B., Amerena, J. V., Attia, J., Bajorek, B. V., Chan, K. H., Connell, C., Freedman, B., Ferguson, C., Hall, T. L., Haqqani, H. M., et al. (2018) · Heart Lung and Circulation · doi:10.1016/j.hlc.2018.06.1043 · Cited by 328 · see citing works
Osmancik, P. P., Heřman, D., Neužil, P., Hála, P., Táborský, M., Kala, P., Poloczek, M., Šťásek, J., Haman, L., Branny, M., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.10.023 · Cited by 313 · see citing works
Self-citationReddy, V. Y., Gibson, D. N., Kar, S., O’Neill, W. W., Doshi, S. K., Horton, R., Buchbinder, M., Gordon, N. T., & Holmes, D. R. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2016.10.010 · Cited by 258 · see citing works
Self-citation2020 Clinical guidelines for Atrial fibrillation and atrial flutter
Arakelyan, M. S., Bockeria, L. A., Vasilieva, E., Sp, G., Golukhova, E. Z., Gorev, M. V., Davtyan, K. V., Drapkina, O. M., Станиславовна, К. Е., Kuchinskaya, Е. А., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4594 · Cited by 255 · see citing works
Tzikas, A., Holmes, D. R., Gafoor, S. A., Ruiz, C. E., Blomström‐Lundqvist, C., Diener, H., Cappato, R., Kar, S., Lee, R. J., Byrne, R. A., et al. (2016) · EP Europace · doi:10.1093/europace/euw141 · Cited by 216 · see citing works
Self-citationSaw, J., Tzikas, A., Shakir, S., Gafoor, S. A., Omran, H., Nielsen‐Kudsk, J. E., Kefer, J., Aminian, A., Berti, S. L., Santoro, G., et al. (2017) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2016.11.029 · Cited by 214 · see citing works
Self-citationLiu, L., Li, Z., Zhou, H., Duan, W., Huo, X., Xu, W., Li, S., Nie, X., Liu, H., Liu, J., et al. (2023) · Stroke and Vascular Neurology · doi:10.1136/svn-2023-002998 · Cited by 227 · see citing works
Klijn, C. J. M., Paciaroni, M., Berge, E., Korompoki, E., Kõrv, J., Lal, A., Jukka Putaala, A., & Werring, D. J. (2019) · European Stroke Journal · doi:10.1177/2396987319841187 · Cited by 213 · see citing works
Ko, D., Chung, M. K., Evans, P. T., Benjamin, E. J., & Helm, R. H. (2024) · JAMA · doi:10.1001/jama.2024.22451 · Cited by 225 · see citing works
Korsholm, K., Berti, S. L., Iriart, X., Saw, J., Wang, D. D., Cochet, H., Chow, D. H. F., Clemente, A., Backer, O. D., Jensen, J. M., et al. (2019) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2019.08.054 · Cited by 205 · see citing works
JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias
Nogami, A., Kurita, T., Abe, H., Andò, K., Ishikawa, T., Imai, K., Usui, A., Okishige, K., Kusano, K., Kumagai, K., et al. (2021) · Circulation Journal · doi:10.1253/circj.cj-20-0637 · Cited by 203 · see citing works
2017 consensus of the Asia Pacific Heart Rhythm Society on stroke prevention in atrial fibrillation
Chiang, C., Okumura, K., Zhang, S., Chao, T., Siu, C., Lim, T. W., Saxena, A., Takahashi, Y., & Teo, W. S. (2017) · Journal of Arrhythmia · doi:10.1016/j.joa.2017.05.004 · Cited by 198 · see citing works
Left Atrial Appendage Function and Stroke Risk
Yaghi, S. R., Song, C., Gray, W. A., Furie, K. L., Elkind, M. S. V., & Kamel, H. (2015) · Stroke · doi:10.1161/strokeaha.115.011273 · Cited by 176 · see citing works
Lampert, R., Chung, E. H., Ackerman, M. J., Arroyo, A. R., Darden, D., Deo, R., Dolan, J., Etheridge, S. P., Gray, B. R., Harmon, K. G., et al. (2024) · Heart Rhythm · doi:10.1016/j.hrthm.2024.05.018 · Cited by 167 · see citing works
JCS/JHRS 2019 guideline on non‐pharmacotherapy of cardiac arrhythmias
Nogami, A., Kurita, T., Abe, H., Andò, K., Ishikawa, T., Imai, K., Usui, A., Okishige, K., Kusano, K., Kumagai, K., et al. (2021) · Journal of Arrhythmia · doi:10.1002/joa3.12491 · Cited by 164 · see citing works
Tzikas, A., Holmes, D. R., Gafoor, S. A., Ruiz, C. E., Blomström‐Lundqvist, C., Diener, H., Cappato, R., Kar, S., Lee, R. J., Byrne, R. A., et al. (2016) · EuroIntervention · doi:10.4244/eijv12i1a18 · Cited by 164 · see citing works
Self-citationPercutaneous Interventions for Left Atrial Appendage Exclusion
Wunderlich, N. C., Beigel, R., Swaans, M. J., Ho, S. Y., & Siegel, R. J. (2015) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2015.02.002 · Cited by 157 · see citing works
2018 Korean Guideline of Atrial Fibrillation Management
Joung, B., Lee, J., Lee, K. H., Kim, T., Choi, E., Lim, W., Kang, K., Uhm, J., Lim, H. E., Park, J., et al. (2018) · Korean Circulation Journal · doi:10.4070/kcj.2018.0339 · Cited by 154 · see citing works
SCAI/HRS expert consensus statement on transcatheter left atrial appendage closure
Saw, J., Holmes, D. R., Cavalcante, J. L., Freeman, J. V., Goldsweig, A. M., Kavinsky, C. J., Moussa, I. D., Munger, T. M., Price, M. J., Reisman, M., et al. (2023) · Heart Rhythm · doi:10.1016/j.hrthm.2023.01.007 · Cited by 140 · see citing works
Self-citationImpact of Peridevice Leak on 5-Year Outcomes After Left Atrial Appendage Closure
Dukkipati, S. R., Holmes, D. R., Doshi, S. K., Kar, S., Singh, S. M., Gibson, D. N., Price, M. J., Natale, A., Mansour, M., Sievert, H., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.04.062 · Cited by 140 · see citing works
Self-citationLee, R., Vassallo, P., Kruse, J. T., Malaisrie, S. C., Rigolin, V. H., Andrei, A., & McCarthy, P. M. (2016) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2016.06.009 · Cited by 138 · see citing works
Antithrombotic Therapy After Left Atrial Appendage Occlusion in Patients With Atrial Fibrillation
Freeman, J. V., Higgins, A. Y., Wang, Y., Du, C., Friedman, D. J., Daimee, U. A., Minges, K. E., Pereira, L., Goldsweig, A. M., Price, M. J., et al. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.02.047 · Cited by 138 · see citing works
Self-citationAtrial fibrillation and stroke: State-of-the-art and future directions
Elsheikh, S., Hill, A. M., Irving, G. J., Lip, G. Y. H., & Abdul‐Rahim, A. H. (2023) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2023.102181 · Cited by 149 · see citing works
Masci, A., Barone, L., Dede’, L., Fedele, M., Tomasi, C., Quarteroni, A. M., & Corsi, C. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2018.01938 · Cited by 129 · see citing works
The prothrombotic state in atrial fibrillation: pathophysiological and management implications
Khan, A. A., & Lip, G. Y. H. (2018) · Cardiovascular Research · doi:10.1093/cvr/cvy272 · Cited by 123 · see citing works
Bergmann, M., Betts, T. R., Sievert, H., Schmidt, B., Pokushalov, E., Kische, S., Schmitz, T., Meincke, F., Steín, K. M., Boersma, L. V. A., et al. (2017) · EuroIntervention · doi:10.4244/eij-d-17-00042 · Cited by 122 · see citing works
Self-citationPracoń, R., Bangalore, S., Dzielińska, Z., Konka, M., Kępka, C., Kruk, M. B. P., Kaczmarska-Dyrda, E., Petryka, J., Bujak, S., Solecki, M., et al. (2018) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.117.005997 · Cited by 122 · see citing works
Rocca, D. G. D., Magnocavallo, M., Biase, L. D., Mohanty, S., Trivedi, C. G., Tarantino, N. M., Gianni, C., Lavalle, C., Niekerk, C. J. V., Romero, J. E., et al. (2021) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2021.07.031 · Cited by 122 · see citing works
Main, M. L., Fan, D., Reddy, V. Y., Holmes, D. R., Gordon, N. T., Coggins, T. R., House, J. A., Liao, L., Rabineau, D., Latus, G. G., et al. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.01.039 · Cited by 121 · see citing works
Self-citationNielsen‐Kudsk, J. E., Korsholm, K., Damgaard, D., Valentin, J. B., Diener, H., Camm, A. J., & Johnsen, S. P. (2021) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2020.09.051 · Cited by 120 · see citing works
Korsholm, K., Nielsen, K. M., Jensen, J. M., Jensen, H. K., Andersen, G., & Nielsen‐Kudsk, J. E. (2017) · EuroIntervention · doi:10.4244/eij-d-16-00726 · Cited by 119 · see citing works
Tzikas, A., Gafoor, S. A., Meerkin, D., Freixa, X., Cruz‐González, I., Lewalter, T., Saw, J., Berti, S. L., Nielsen‐Kudsk, J. E., Ibrahim, R., et al. (2016) · EuroIntervention · doi:10.4244/eijv11i13a292 · Cited by 117 · see citing works
Self-citationCaliskan, E., Sahin, A., Yılmaz, M., Seifert, B., Hinzpeter, R., Alkadhi, H., Cox, J. L., Holubec, T., Reser, D., Falk, V., et al. (2017) · EP Europace · doi:10.1093/europace/eux211 · Cited by 118 · see citing works
Kefer, J., Tzikas, A., Freixa, X., Shakir, S., Gafoor, S. A., Nielsen‐Kudsk, J. E., Berti, S. L., Santoro, G., Aminian, A., Landmesser, U., et al. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.01.003 · Cited by 114 · see citing works
Self-citationBleeding Outcomes After Left Atrial Appendage Closure Compared With Long-Term Warfarin
Price, M. J., Reddy, V. Y., Valderrábano, M., Halperin, J. L., Gibson, D. N., Gordon, N. T., Huber, K. C., & Holmes, D. R. (2015) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2015.08.035 · Cited by 112 · see citing works
Self-citationIntracerebral haemorrhage — mechanisms, diagnosis and prospects for treatment and prevention
Seiffge, D. J., Fandler‐Höfler, S., Du, Y., Goeldlin, M. B., Jolink, W. M. T., Klijn, C. J. M., & Werring, D. J. (2024) · Nature Reviews Neurology · doi:10.1038/s41582-024-01035-w · Cited by 111 · see citing works
Panikker, S., Jarman, J. W. E., Virmani, R., Kutys, R., Haldar, S., Lim, E., Butcher, C., Khan, H. R., Mantziari, L., Nicol, E. D., et al. (2016) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.115.003710 · Cited by 110 · see citing works
Stroke Prevention in Atrial Fibrillation
Katsanos, A. H., Kamel, H., Healey, J. S., & Hart, R. G. (2020) · Circulation · doi:10.1161/circulationaha.120.049768 · Cited by 106 · see citing works
Huang, H., Liu, Y., Xu, Y., Wang, Z., Li, Y., Cao, K., Zhang, S., Yang, Y., Yang, X., Huang, D., et al. (2017) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2017.06.072 · Cited by 106 · see citing works
Korsholm, K., Jensen, J. M., & Nielsen‐Kudsk, J. E. (2017) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2017.06.057 · Cited by 105 · see citing works
SCAI/HRS Expert Consensus Statement on Transcatheter Left Atrial Appendage Closure
Saw, J., Holmes, D. R., Cavalcante, J. L., Freeman, J. V., Goldsweig, A. M., Kavinsky, C. J., Moussa, I. D., Munger, T. M., Price, M. J., Reisman, M., et al. (2023) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2023.01.011 · Cited by 102 · see citing works
Self-citationPercutaneous Left Atrial Appendage Closure
Asmarats, L., & Rodés‐Cabau, J. (2017) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.117.005359 · Cited by 103 · see citing works
Nielsen, J. C., Lin, Y., Figueiredo, M. J. D. O., Shamloo, A. S., Alfie, A., Bovéda, S., Dagres, N., Toro, D. D., Eckhardt, L. L., Ellenbogen, K. A., et al. (2020) · Journal of Arrhythmia · doi:10.1002/joa3.12338 · Cited by 102 · see citing works
Nielsen, J. C., Lin, Y.-J., de Oliveira Figueiredo, M. J., Sepehri Shamloo, A., Alfie, A., Boveda, S., Dagres, N., Di Toro, D., Eckhardt, L. L., Ellenbogen, K., et al. (2020) · EP Europace · doi:10.1093/europace/euaa065 · Cited by 98 · see citing works
Outcomes of left atrial appendage occlusion using the AtriClip device: a systematic review
Toale, C., Fitzmaurice, G. J., Eaton, D. A., Lyne, J. C., & Redmond, K. (2019) · Interactive Cardiovascular and Thoracic Surgery · doi:10.1093/icvts/ivz156 · Cited by 98 · see citing works
Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF
Reddy, V. Y., Akehurst, R. L., Armstrong, S. O., Amorosi, S. L., Beard, S. M., & Holmes, D. R. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.09.084 · Cited by 97 · see citing works
Self-citationSøndergaard, L., Wong, Y.-H., Reddy, V. Y., Boersma, L. V. A., Bergmann, M., Doshi, S. K., Kar, S., Sievert, H., Wehrenberg, S., Steín, K. M., et al. (2019) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2019.04.004 · Cited by 96 · see citing works
Self-citationElectrophysiological Manifestations of Cardiac Amyloidosis
Hartnett, J., Jaber, W. A., Maurer, M. S., Sperry, B. W., Hanna, M. A., Collier, P. H., Patel, D. R., Wazni, O. M., & Donnellan, E. (2021) · JACC CardioOncology · doi:10.1016/j.jaccao.2021.07.010 · Cited by 95 · see citing works
Secondary stroke prevention in people with atrial fibrillation: treatments and trials
Seiffge, D. J., Cancelloni, V., Räber, L., Paciaroni, M., Metzner, A., Kirchhof, P. F., Fischer, U., Werring, D. J., Shoamanesh, A., & Caso, V. (2024) · The Lancet Neurology · doi:10.1016/s1474-4422(24)00037-1 · Cited by 98 · see citing works
Angiolillo, D. J., Goodman, S. G., Bhatt, D. L., Eikelboom, J. W., Price, M. J., Moliterno, D. J., Cannon, C. P., Tanguay, J., Granger, C. B., Mauri, L., et al. (2016) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.116.004395 · Cited by 90 · see citing works
Self-citationWintgens, L. I. S., Romanov, A., Phillips, K. P., Ballesteros, G., Swaans, M. J., Folkeringa, R., García‐Bolao, I., Pokushalov, E., & Boersma, L. V. A. (2018) · EP Europace · doi:10.1093/europace/euy025 · Cited by 89 · see citing works
Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation
Doshi, S. K., Kar, S., Nair, D. G., Waggoner, T. E., Agarwal, H., Moussavian, M., کاشانی, ا., Oza, S. R., Feldman, L. A., Sadhu, A. K., et al. (2026) · New England Journal of Medicine · doi:10.1056/nejmoa2517213 · Cited by 88 · see citing works
Self-citationCochet, H., Iriart, X., Sridi, S., Camaioni, C., Corneloup, O., Montaudon, M., Laurent, F., Selmi, W., Renou, P., Jalal, Z., et al. (2018) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jey010 · Cited by 88 · see citing works
Nielsen‐Kudsk, J. E., Johnsen, S. P., Wester, P. O., Damgaard, D., Airaksinen, J. K. E., Lund, J., Backer, O. D., Pakarinen, S., Odenstedt, J., Vikman, S., et al. (2017) · EuroIntervention · doi:10.4244/eij-d-17-00201 · Cited by 85 · see citing works
Left Atrial Appendage Occlusion for Stroke Prevention in Nonvalvular Atrial Fibrillation
Collado, F. M. S., von Buchwald, C. M. L., Anderson, C. K., Madan, N., Suradi, H. S., Huang, H. D., Jneid, H. M., & Kavinsky, C. J. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.121.022274 · Cited by 82 · see citing works
Phillips, K. P., Walker, D. T., & Humphries, J. (2015) · Journal of Arrhythmia · doi:10.1016/j.joa.2015.11.001 · Cited by 81 · see citing works
Managing atrial fibrillation in the very elderly patient: challenges and solutions
Letsas, Κ. P., Karamichalakis, N., Vlachos, K. G., Georgopoulos, S., Bakalakos, A., Efremidis, M., & Sideris, A. (2015) · Vascular Health and Risk Management · doi:10.2147/vhrm.s83664 · Cited by 82 · see citing works
The left atrial appendage: from embryology to prevention of thromboembolism
Patti, G., Pengo, V., Marcucci, R., Cirillo, P. L., Renda, G., Santilli, F., Calabrò, P., Caterina, A. R. D., Cavallari, I., Ricottini, E., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw159 · Cited by 78 · see citing works
Atrial fibrillation type and renal dysfunction as important predictors of left atrial thrombus
Kapłon‐Cieślicka, A., Budnik, M., Gawalko, M. M., Peller, M., Gorczyca−Michta, I., Michalska, A., Babiarz, A., Bodys-Pełka, A., Ulińśki, R., Żochowski, M., et al. (2019) · Heart · doi:10.1136/heartjnl-2018-314492 · Cited by 77 · see citing works
Chow, D. H. F., Bieliauskas, G., Sawaya, F., Millán-Iturbe, Ó., Kofoed, K. F., Søndergaard, L., & Backer, O. D. (2017) · Open Heart · doi:10.1136/openhrt-2017-000627 · Cited by 77 · see citing works
Thoracoscopic Left Atrial Appendage Clipping
van Laar, C., Verberkmoes, N. J., van Es, H. W., Lewalter, T., Dunnington, G. H., STARK, S. I., Longoria, J., Hofman, F. H., Pierce, C. M., Kotecha, D., et al. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.03.009 · Cited by 77 · see citing works
Vestergaard, A. S., Skjøth, F., Larsen, T. B., & Ehlers, L. H. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188482 · Cited by 76 · see citing works
Laparoscopic cholecystectomy for the various types of gallbladder inflammation: a prospective trial.
Eldar, S., Sabo, E., Nash, E., Abrahamson, J., & Matter, I. (1998) · PubMed · Cited by 76 · see citing works
JCS/JSCVS 2018 Guideline on Revascularization of Stable Coronary Artery Disease
Nakamura, M., Yaku, H., Ako, J., Arai, H., Asai, T., Chikamori, T., Daida, H., Doi, K., Fukui, T., Ito, T., et al. (2022) · Institutional Repositories DataBase (IRDB) · doi:10.1253/circj.cj-20-1282 · Cited by 70 · see citing works
Gloekler, S., Shakir, S., Doblies, J., Khattab, A. A., Praz, F., Guérios, Ê. E., Koermendy, D., Stortecky, S., Pilgrim, T., Buellesfeld, L., et al. (2015) · Clinical Research in Cardiology · doi:10.1007/s00392-015-0828-1 · Cited by 71 · see citing works
2015 ACC/HRS/SCAI Left Atrial Appendage Occlusion Device Societal Overview
Masoudi, F. A., Calkins, H. G., Kavinsky, C. J., Drozda, J. P., Gainsley, P., Slotwiner, D. J., & Turi, Z. G. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.06.028 · Cited by 69 · see citing works
Backer, O. D., Iriart, X., Kefer, J., Nielsen‐Kudsk, J. E., Aminian, A., Rosseel, L., Kofoed, K. F., Odenstedt, J., Berti, S. L., Saw, J., et al. (2023) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2023.01.008 · Cited by 69 · see citing works
Korsholm, K., Samaras, A., Andersen, A., Jensen, J. M., & Nielsen‐Kudsk, J. E. (2020) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2020.06.028 · Cited by 67 · see citing works
Commonly Used Dietary Supplements on Coagulation Function during Surgery
Wang, C., Moss, J., & Yuan, C. (2015) · Medicines · doi:10.3390/medicines2030157 · Cited by 64 · see citing works
Atrial Fibrillation in Heart Failure: a Therapeutic Challenge of Our Times
Batul, S. A., & Gopinathannair, R. (2017) · Korean Circulation Journal · doi:10.4070/kcj.2017.0040 · Cited by 63 · see citing works
The left atrial appendage in humans: structure, physiology, and pathogenesis
Karim, N., Ho, S. Y., Nicol, E. D., Li, W., Zemrak, F., Markides, V., Reddy, V. Y., & Wong, T. (2019) · EP Europace · doi:10.1093/europace/euz212 · Cited by 62 · see citing works
Self-citationRocca, D. G. D., Horton, R., Biase, L. D., Bassiouny, M., Al‐Ahmad, A., Mohanty, S., Gasperetti, A., Natale, V. N., Trivedi, C. G., Gianni, C., et al. (2020) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2019.10.022 · Cited by 62 · see citing works
How will machine learning inform the clinical care of atrial fibrillation?
Siontis, K. C., Yao, X., Pirruccello, J. P., Philippakis, A. A., & Noseworthy, P. A. (2020) · Circulation Research · doi:10.1161/circresaha.120.316401 · Cited by 61 · see citing works
Ellis, C. R., Aznaurov, S. G., Patel, N., Williams, J. R., Sandler, K. L., Hoff, S. J., Ball, S. K., Whalen, S. P., & Carr, J. J. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2017.03.008 · Cited by 63 · see citing works
Kubo, S., Mizutani, Y., Meemook, K., Nakajima, Y., Hussaini, A., & Kar, S. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2017.05.006 · Cited by 60 · see citing works
Self-citationLeft atrial appendage closure using AMPLATZER™ devices: A large, multicenter, Italian registry
Berti, S. L., Santoro, G., Brscic, E., Montorfano, M., Vignali, L., Danna, P., Tondo, C., D’Amico, G., Stabile, A., Saccà, S., et al. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.07.052 · Cited by 59 · see citing works
- Authors
- Reddy, V. Y., Sievert, H., Halperin, J., Doshi, S. K., Buchbinder, M., Neuzil, P., Huber, K., Whisenant, B., Kar, S., Swarup, V., Gordon, N., & Holmes, D.
- Affiliations
- Na Homolce Hospital (CZ)
- Cardiovascular Center Frankfurt (DE)
- Icahn School of Medicine at Mount Sinai (US)
- Saint John's Health Center (US)
- Foundation for Cardiovascular Medicine, La Jolla, California
- Homolka Hospital, Prague, Czech Republic
- Saint Luke's Hospital (US)
- Intermountain Medical Center (US)
- Cedars-Sinai Medical Center (US)
- Arizona Heart Rhythm Center, Scottsdale
- Boston Scientific (United States) (US)
- Mayo Clinic (US)
- Corresponding author
- Reddy, Vivek Y.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2014-11-19
- Volume
- 312
- Issue
- 19
- Pages
- 1988
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2112970567
- Cited by
- 1,018
- References
- 25
- Citations by year
- 2026: 73 · 2025: 86 · 2024: 87 · 2023: 102 · 2022: 97 · 2021: 84 · 2020: 75 · 2019: 58 · 2018: 87 · 2017: 104 · 2016: 75 · 2015: 77 · 2014: 6 · 2013: 2 · 2012: 1
- FWCI
- 59.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- left atrial appendage closure, warfarin, atrial fibrillation, stroke prevention, systemic embolism, cardiovascular mortality, non-inferiority, non-valvular atrial fibrillation, CHADS2 score, anticoagulation, international normalized ratio, bleeding complications, quality of life, patient satisfaction, patient-reported outcomes
- MeSH terms
- Aged, Aged, 80 and over, Anticoagulants, Atrial Fibrillation, Bayes Theorem, Cardiovascular Diseases, Embolism, Female, Cardiac Catheterization, Humans, Male, Middle Aged, Risk Factors, Warfarin, Survival Analysis, Treatment Outcome, Prosthesis Implantation, Atrial Appendage, Stroke
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
