TCT-742 Risks of Major Bleeding and Hospitalization for Falls After Left Atrial Appendage Occlusion in Patients with Atrial Fibrillation and History of Falls: A Propensity-Matched Analysis

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: In patients with atrial fibrillation (AF), falls while on anticoagulation increase bleeding risk. Left atrial appendage occlusion (LAAO) offers an alternative to anticoagulation for stroke prevention in AF, but whether LAAO reduces bleeding and hospitalization for falls is unknown. Methods: In the TriNetX research network, patients with AF and history of falls were identified, and outcomes were compared between those who underwent LAAO (n=2904) vs. those who did not (n=33,956). Propensity score matching yielded 2853 patients per group. Major bleeding, hospitalization for falls, and their composite were assessed at 30 days and 1 year using Kaplan-Meier survival and Cox regression to estimate hazard ratios (HRs) with confidence intervals (CIs). Major bleeding was defined by transfusion, hemoglobin ≤7.5 g/dL, or diagnoses of intracranial, gastrointestinal, retroperitoneal, thoracic, or pericardial bleeding. Results: At 30 days, LAAO was associated with lower risk of major bleeding (HR 0.64; 95%CI 0.56–0.73), hospitalization for falls (HR 0.45; 95 CI 0.39–0.51; p<0.01), and their composite (HR 0.53; 95%CI 0.48–0.58; p<0.01). At 1 year, the LAAO group continued to show lower risks of major bleeding (HR 0.83; 95%CI 0.75–0.91; p<0.01), hospitalization for falls (HR 0.60; 95%CI 0.55–0.66; p<0.01), and their composite (HR 0.68; 95%CI 0.64–0.74; p<0.01; Figure). [Formula presented] Conclusion: In patients with AF and falls, LAAO was associated with lower risks of major bleeding, hospitalization for falls, and their composite at 30 days and 1 year. These findings support LAAO in patients at high risk of anticoagulation-related harm. Categories: STRUCTURAL: Left Atrial Appendage Exclusion

Volume

86

Issue

17

First Page

B322

Last Page

B323

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