TCT-739 Left Atrial Appendage Closure in Patients with Dementia: Data from The National Inpatient Sample Database

Document Type

Conference Proceeding

Publication Date

10-22-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation. Patients with dementia are at increased risk of falls and OAC might be contraindicated. We aimed to evaluate the safety of LAAC in patients with dementia. Methods: The National Inpatient Sample Database was used to identify patients who underwent LAAC between 2018 and 2021. In-hospital complications include mortality, cardiac arrest, myocardial infarction (MI), stroke, pericardial effusion or tamponade, vasopressor use or acute kidney injury (AKI). Multivariate logistic regression analyses were performed. Results: A total of 120,935 patients were included, of whom 4,060 (3%) had dementia. Mean age was 76 (±8) years with 50,165 (42%) females and 103,780 (86%) identified as White. After adjusting for baseline characteristics, dementia was independently associated with significantly higher odds of mortality (OR: 3.46, 95% CI: 1.99-6.02, p<0.0001), myocardial infarction (OR: 4.74, 95% CI: 3.27-6.88, p<0.0001), AKI (OR: 2.15, 95% CI: 1.84-2.51, p<0.0001) stroke (OR: 2.97, 95% CI: 2.35-3.74, p<0.0001) pericardial effusion or tamponade (OR: 2.76, 95% CI: 2.02-3.77, p<0.0001) vasopressor use (OR: 1.68, 95% CI: 1.21-2.33, p=0.001) and cardiac arrest (OR: 2.46, 95% CI: 1.26-4.78, p=0.008) [Formula presented] Conclusion: Patients with dementia undergoing LAAC are at a higher risk of worse in-hospital outcomes. These findings underscore the importance of careful patient selection, risk assessment, and individualized decision-making when considering LAAC in this population. Categories: STRUCTURAL: Left Atrial Appendage Exclusion

Volume

86

Issue

17

First Page

B321

Last Page

B322

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