ReviewAnnals of medicine and surgery (2012)2025
Impact of left atrial appendage closure on long-term stroke risk in atrial fibrillation: an umbrella review.
Review in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF). While efficacy is established for follow-up periods up to 5 years, longer-term (>5 years) stroke outcomes remain underexplored, particularly across diverse AF populations and LAAC approaches (percutaneous and surgical). This paper synthesizes systematic reviews and meta-analyses evaluating the impact of LAAC on stroke risk in AF patients, focusing on ischemic and hemorrhagic stroke, device-specific outcomes, antithrombotic regimens, and valvular vs. non-valvular AF differences. We searched PubMed, Embase, Scopus, Cochrane Library, and Web of Science for systematic reviews and meta-analyses on LAAC and stroke outcomes in AF, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Included reviews reported stroke outcomes. Data were extracted on study characteristics, stroke outcomes, complications (e.g., device-related thrombosis), and subgroups. Quality was assessed using AMSTAR-2. Narrative synthesis was performed. Ten reviews (over 50 000 patients) were included, with follow-ups up to 5 years. LAAC reduced hemorrhagic stroke [e.g., hazard ratio 0.22, 95% confidence interval (CI) 0.08-0.61] and was non-inferior to OAC for all-cause stroke (OR 0.71, 95% CI 0.51-1.00). Surgical LAAC in valvular AF reduced stroke risk (Relative Risk (RR) 0.87, 95% CI 0.84-0.91). Complications like peri-device leaks increased ischemic stroke risk in non-valvular AF. No reviews reported >5-year stroke data. AMSTAR-2 ratings were moderate to high. LAAC effectively reduces hemorrhagic stroke risk in AF, with comparable all-cause stroke prevention to OAC up to 5 years. Longer-term (>5 years) data and valvular AF outcomes are limited, warranting further research.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.