Safety and efficacy of left atrial appendage closure in cancer versus non-cancer patients: a systematic review and meta-analysis

Résumé fourni par la source

There is an ongoing debate regarding the safety and efficacy of left atrial appendage occlusion (LAAO) for atrial fibrillation in patients with cancer. We searched PubMed and Scopus from the database's inception until November 2024 and included studies comparing cancer patients with non-cancer patients undergoing left atrial appendage closure for atrial fibrillation. Our primary outcome was short-term mortality. Secondary outcomes were ischemic stroke, major bleeding, device complications, and pericardial complications. For the dichotomous outcomes, risk ratios (RR) were used, whereas generic inverse variance (GIV) was used to pool the RRs and corresponding 95% confidence interval (95% CI). A random effects model was used to evaluate all the outcomes. Our analysis showed a significantly higher rate of short-term mortality in patients with cancer as compared to non-cancer patients (RR=2.07; 95% CI [1.12 to 3.84]; p=0.02). From secondary outcomes, pericardial complications showed a significantly higher risk in cancer patients (RR: 2.17, 95% CI [1.51, 3.12]; p<0.0001). Meanwhile, other secondary outcomes were found to be insignificant. LAAO in cancer patients was significantly associated with higher short-term mortality and pericardial complications.

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