ANTITHROMBOTIC TREATMENT AFTER LEFT ATRIAL APPENDAGE OCCLUSION IN OLDER ATRIAL FIBRILLATION PATIENTS - Poster presentation - 1

Sep 29, 2026

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Left atrial appendage occlusion (LAAO) serves as an alternative to oral anticoagulants for stroke prevention in nonvalvular atrial fibrillation, yet adherence to postprocedural antithrombotic protocols in real-world care remains understudied. Using Optum claims data from 2015–2024, outcomes were analyzed in 16,304 first-time LAAO patients. Results showed substantial protocol deviation, including low follow-through with standard postprocedural management despite frequent TEE use.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Background

Study Design and Definitions

Patient Characteristics

TEE Use and Protocol Deviations

Discontinuation and Prolonged OAC Use

Associated Factors

Conclusions

Innovation in Aging, 2025, Vol. 9, No. S2 1003 SESSION 7510 (POSTER) PHARMACOLOGY Abstract citation ID: igaf122.3384 ANTITHROMBOTIC TREATMENT AFTER LEFT ATRIAL APPENDAGE OCCLUSION IN OLDER ATRIAL FIBRILLATION PATIENTS Xiaojuan Liu1, Sebastian Schneeweiss1, Daniel Singer2, Jerry Avorn1, E. Kevin Heist2, and Joshua Lin1, 1. Brigham and Women’s Hospital, Boston, Massachusetts, United States, 2. Massachusetts General Hospital, Boston, Massachusetts, United States Left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulants (OAC) for stroke prevention in nonvalvular 1004 Innovation in Aging, 2025, Vol. 9, No. S2 atrial fibrillation (NVAF); however, real-world data on adherence to its postprocedural treatment protocol remain limited. We evaluated post-LAAO antithrombotic treatment patterns in a cohort of 16304 NVAF patients (mean [SD] age = 78 [6]; 47% female; CHA2DS2-VASc score = 5.0 [1.5]) undergoing first-time LAAO using Optum claims data 2015-2024 . OAC discontinuation was defined as a ≥60-day gap in supply, and prolonged OAC use was operationally defined as either (1) an OAC refill following a TEE performed 30–90 days post-implantation or (2) OAC refill beyond 90 days post-implantation, regardless of TEE completion. Among LAAO recipients, 9844 (60%) received concomitant OAC and 3499 (10%) received P2Y12 inhibitor at implantation. Transesophageal echocardiography (TEE) was performed in 11237 (69%) patients at 45 (±15) days. Among OAC users (n = 9844), 30% and 85% discontinued OAC by 45 days and 6 months post-implantation, respectively; only 23% patients followed the standard postprocedural protocol. Common deviation from the protocol included no TEE at 45 (±15) days (30%), early OAC discontinued (22%), continued OAC use post-TEE (10%), and P2Y12 inhibitor initiated early or not initiated (10%) . Prolonged OAC use was observed in 1970 patients. Factors associated with a higher likelihood of prolonged OAC use included older age, Black race, cardio ablation, and a longer duration of prior OAC use. These findings suggest moderate to low adherence to the LAAO postprocedural protocol, warranting further evaluation of the clinical impact of these adherence patterns.

FAQs

What real-world question does this study address after LAAO?

It evaluates how antithrombotic treatment is managed after left atrial appendage occlusion and whether patients follow the intended postprocedural treatment protocol.

How did the study define oral anticoagulant (OAC) discontinuation and prolonged OAC use?

OAC discontinuation was defined as a gap of at least 60 days in medication supply. Prolonged OAC use required either an OAC refill after a TEE 30–90 days post-implant or an OAC refill beyond 90 days, regardless of TEE completion.

What were the main findings regarding adherence to the postprocedural protocol?

Among OAC users, discontinuation occurred in a substantial share by 45 days and further by 6 months, and only a minority followed the standard postprocedural protocol, with common deviations including missing TEE and early or continued OAC use.

Sep 29, 2026

Uploaded by Muffet