LAAOS III
Left Atrial Appendage Occlusion Study III
Patient / Population Intervention / Exposure Comparison Outcome
In 4,660 patients with atrial fibrillation undergoing cardiac surgery, surgical left atrial appendage occlusion reduced ischaemic stroke or systemic embolism compared with no occlusion.
N
4,811
Design
Multicentre double-blind RCT
Endpoint
Ischaemic stroke or systemic embolism
Relevance
2
Result4.8% vs 7.0% over mean 3.8 years (HR 0.67, 95% CI 0.53-0.85; P=0.001). Benefit additive to continued oral anticoagulation.
Whitlock RP, et al. N Engl J Med. 2021;384(22):2081-2091. 10.1056/NEJMoa2101897
Discussion & critique
Nearly all patients continued anticoagulation, so occlusion is an add-on and not a substitute. Supports concomitant surgical LAA occlusion during cardiac surgery in AF patients.