[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-425735-105":59,"doc-detail-425735-en":134},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":127,"head_meta":129,"extra_data":131,"updated_unix":133},105,"en","left-atrial-appendage-occlusion-versus-oral-anticoagulants-in-older-atrial-fibrillation-patients","Left Atrial Appendage Occlusion Versus Oral Anticoagulants in Older Atrial Fibrillation Patients","","Real-world evidence comparing left atrial appendage occlusion (LAAO) devices with oral anticoagulants (OAC) in nonvalvular atrial fibrillation (NVAF) remains limited. This study emulated a target trial and assessed effectiveness and safety in 35,326 NVAF patients aged ≥65 years using Medicare 2016–2020 and Optum 2016–2024 data, with 1:1 propensity score matching. LAAO users showed higher 2-year major bleeding (RR 1.29), but lower bleeding after 6 months (0.64). Stroke rates were higher over 2 years (1.43) yet not significant beyond 6 months; mortality showed no association.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/left-atrial-appendage-occlusion-versus-oral-anticoagulants-in-older-atrial-fibrillation-patients/425735/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/left-atrial-appendage-occlusion-versus-oral-anticoagulants-in-older-atrial-fibrillation-patients/425735.png","ImageObject",300,407,{"name":92,"@type":93},"\tCallum ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What comparison does the study evaluate in older NVAF patients?","Question",{"text":112,"@type":113},"The study compares left atrial appendage occlusion (LAAO) devices versus oral anticoagulant (OAC) therapy.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the LAAO and OAC groups created for analysis?",{"text":117,"@type":113},"Patients receiving LAAO on OAC were 1:1 matched to patients taking OAC alone using propensity score matching based on 75 pre-treatment covariates.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study find regarding major bleeding and its timing?",{"text":121,"@type":113},"Over 2 years, LAAO was associated with a higher major bleeding rate, but beyond 6 months after implantation, LAAO showed a 36% reduction in bleeding rate.",{"name":123,"@type":110,"acceptedAnswer":124},"Did LAAO affect mortality compared with OAC?",{"text":125,"@type":113},"No evidence of an association with mortality was found.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},425735,1790763566,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":24,"preview_page_count":4},137451211410,"https://ap-avatar.wpscdn.com/avatar/2000bb0a9246f588df?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786362646172706240","1004 Innovation in Aging, 2025, Vol. 9, No. S2  \nAbstract citation ID: igaf122.3387  \nLEFT ATRIAL APPENDAGE OCCLUSION VERSUS ORAL ANTICOAGULANTS IN OLDER ATRIAL  \nFIBRILLATION PATIENTS  \nXiaojuan Liu1, Sebastian Schneeweiss1, Daniel Singer2,  \nJerry Avorn1, E. Kevin Heist2, and Joshua Lin1, 1. Brigham and Women’s Hospital, Boston, Massachusetts, United States,  \n2. Massachusetts General Hospital, Boston, Massachusetts, United States  \nReal-world evidence comparing left atrial appendage occlusion (LAAO) devices to oral anticoagulants (OAC) in nonvalvular atrial fibrillation (NVAF) remain limited. We emulated a target trial and evaluated the effectiveness and safety of LAAO device versus OAC in 35326 NVAF patients (aged ≥65 years, CHA2DS2-VASc score ≥2 [males] or ≥ 3 [females]) using Medicare 2016-2020 and Optum 2016-2024 data. LAAO recipients on OAC (warfarin, apixaban, rivaroxaban, or dabigatran) at implantation (index date) were 1:1 matched to patients who  \nInnovation in Aging, 2025, Vol. 9, No. S2 1005  \nreceived these medications alone via propensity score matching based on 75 pre-treatment covariates. Outcomes included hospitalization for major bleeding events, ischemic stroke, and all-cause mortality. Follow-up was censored at 2 years or upon treatment deviation (OAC discontinuation or LAAO implantation in OAC users and OAC continuation beyond 90 days in LAAO users) . Database-specific rate ratios (RR) were estimated via Poisson regression with inverse probability of censoring weighting and pooled using fixed-effect meta-analysis. Compared to OAC users, LAAO users had a higher bleeding rate over 2 years (RR 1.29; 95% CI 1.11-2.49); however, beyond 6 months post-implantation, LAAO users had a 36% reduction in bleeding rate (0.64; 0.51-0.80) . LAAO was also associated with a higher rate of ischemic stroke over 2 years (1.43; 1.10-1.85), thoughthe effect size diminished over time and was no longer statistically significant beyond 6 months (1.16; 0.84-1.62) . We found no evidence of association with mortality. These findings suggest that LAAO may reduce long-term bleeding risk but may carry an early increased risk of bleeding and ischemic stroke compared to OAC.","cbCaiaPjfeJ9pPmR","https://ap.wps.com/l/cbCaiaPjfeJ9pPmR","pdf",51897,"English","# Study Objective\n## Study Design and Population\n## Treatment Comparison and Matching\n## Outcomes and Statistical Approach\n## Results: Bleeding, Stroke, Mortality\n## Interpretation and Clinical Implications","[{\"question\":\"What comparison does the study evaluate in older NVAF patients?\",\"answer\":\"The study compares left atrial appendage occlusion (LAAO) devices versus oral anticoagulant (OAC) therapy.\"},{\"question\":\"How were the LAAO and OAC groups created for analysis?\",\"answer\":\"Patients receiving LAAO on OAC were 1:1 matched to patients taking OAC alone using propensity score matching based on 75 pre-treatment covariates.\"},{\"question\":\"What did the study find regarding major bleeding and its timing?\",\"answer\":\"Over 2 years, LAAO was associated with a higher major bleeding rate, but beyond 6 months after implantation, LAAO showed a 36% reduction in bleeding rate.\"},{\"question\":\"Did LAAO affect mortality compared with OAC?\",\"answer\":\"No evidence of an association with mortality was found.\"}]","Left Atrial Appendage Occlusion Versus Oral Anticoagulants in Older Atrial Fibrillation Patients | PDF",1790638155]