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. 2021 Apr 1;97(5):885-892.
doi: 10.1002/ccd.29282. Epub 2020 Oct 13.

Sex-stratified analysis of the safety of percutaneous left atrial appendage occlusion

Mohammed Osman  1 , Brijesh Patel  1 , Muhammad Bilal Munir  1   2 , Akram Kawsara  1 , Babikir Kheiri  3 , Sudarshan Balla  1 , Ramesh Daggubati  1 , Erin D Michos  4 , Mohamad Alkhouli  5
Affiliations

Sex-stratified analysis of the safety of percutaneous left atrial appendage occlusion

Mohammed Osman et al. Catheter Cardiovasc Interv. .

Abstract

Objectives and background: There is insufficient current evidence about whether sex impacts outcomes of percutaneous left atrial appendage occlusion (LAAO). The aim of this study was to investigate the association between sex and short-term outcomes of LAAO.

Methods: Patients who were hospitalized and underwent LAAO from October 2015 to December 2017 in the National Readmission Database were queried. The primary endpoint of interest was major in-hospital adverse events. Secondary endpoints included, 30-day readmission rate, nonhome discharge, and cost of hospitalization. Propensity score matching (1:1) was performed to compare the outcomes among women and men.

Results: A total of 9,281 patients were included in the current analysis [women = 3,659 (39%); men = 5,622 (61%)]. Comparing women to men, women had lower prevalence of diabetes mellitus (30.6% vs 35.7%, p < .01), heart failure (28.6% vs 30.8%, p = .03), vascular disease (55.5% vs 69.6%, p < .01) and renal failure (18.3% vs 21.2%, p < .01), and higher CHA2 DS2 VASc score (5 [IQR4-6] vs 4 [IQR3-6], p < .01). After propensity-score matching, women had higher rate of major in-hospital adverse events (2.8% vs 1.9%; p < .01), and nonhome discharges (11.4% vs 6.7%; p < .01). Additionally, 30-day readmission rate was higher among women (10% vs 8.6%, p = .03).

Conclusion: Among hospitalized patients undergoing LAAO, women carry higher risk for major in-hospital adverse events, nonhome discharge, and 30-day readmission rates.

Keywords: female; left atrial appendage occlusion; readmission; sex and gender disparity; women.

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