TCT-744 Risk of Recurrent Gastrointestinal Bleeding in Patients with Atrial Fibrillation Treated With or Without Left Atrial Appendage Occlusion: A Propensity-Matched Analysis

Authors

Adham Ramadan
Mohamed Doma
Iuri F. Felix
Ibrahim Kamel
Mahmoud Ismayl
Mahmoud S. Ahmed
Ahmed Mahmoud
Pedro Villablanca, Henry Ford HealthFollow
Christopher DeSimone
Andrew Goldsweig

Recommended Citation

Ramadan A, Doma M, Felix IF, Kamel I, Ismayl M, Ahmed MS, Mahmoud A, Villablanca P, DeSimone C, Goldsweig A. TCT-744 Risk of Recurrent Gastrointestinal Bleeding in Patients with Atrial Fibrillation Treated With or Without Left Atrial Appendage Occlusion: A Propensity-Matched Analysis. J Am Coll Cardiol 2025; 86(17):B323-B324.

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Concomitant atrial fibrillation (AF) and gastrointestinal (GI) bleeding present a clinical challenge due to recurrent bleeding risk associated with anticoagulation for stroke prevention. Left atrial appendage occlusion (LAAO) offers an alternative strategy, but its impact on recurrent GI bleeding remains unknown. Methods: This retrospective, multicenter cohort study used the TriNetX database to identify adults with AF on oral anticoagulation and history of GI bleeding. Patients were stratified by treatment with or without LAAO. 1:1 propensity score-matching (PSM) was employed. The primary outcome was recurrent GI bleeding. Cox regression analysis was used to generate hazard ratios (HRs) with 95% confidence intervals (CIs). Odds ratios (ORs) were used to evaluate effect sizes between groups. Kaplan-Meier curves were used for time-to-event analyses. Results: After PSM, 9259 patients were compared in each group. Mean age was 76.2±7.9 years in the LAAO group and 76.1±9.5 years in the no LAAO group. Approximately 56% of patients in both cohorts were male. Odds of recurrent GI bleeding were consistently lower in patients undergoing LAAO than without LAAO across all follow-up intervals (Figure 1A): at 3 months (OR 0.84; 95%CI 0.78–0.91), 6 months, 1 year, 3 years and 5 years (OR 0.87; 95%CI 0.82–0.92). Kaplan–Meier analysis demonstrated significantly lower risk of recurrent GI bleeding with LAAO (HR 0.80; 95%CI 0.76–0.84; p<0.01; Figure 1B). [Formula presented] Conclusion: In patients with AF and prior GI bleeding, LAAO was associated with significantly lower risk of recurrent GI bleeding at short-term and long-term time intervals. Categories: STRUCTURAL: Left Atrial Appendage Exclusion

Volume

86

Issue

17

First Page

B323

Last Page

B324