Left atrial appendage closure with WATCHMAN in Asian patients: 2 year outcomes from the WASP registry

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dc.contributor.authorPhillips, K.P.
dc.contributor.authorSantoso, T.
dc.contributor.authorSanders, P.
dc.contributor.authorAlison, J.
dc.contributor.authorChan, J.L.K.
dc.contributor.authorPak, H.N.
dc.contributor.authorChandavimol, M.
dc.contributor.authorStein, K.M.
dc.contributor.authorGordon, N.
dc.contributor.authorRazali, O.B.
dc.date.issued2019
dc.description.abstractBackground: Left atrial appendage closure is a non-pharmacological alternative for stroke prevention in high-risk non-valvular atrial fibrillation patients, but has not been widely studied in Asian patients. The prospective WASP registry assessed real-world outcomes for patients undergoing WATCHMAN implant in the Asia-Pacific region. Methods: Data were collected from consecutive patients across 9 centres. Major endpoints included procedural success, safety and long-term outcomes including occurrence of bleeding, stroke/transient ischaemic attack/systemic embolism and all-cause mortality. Results: Subjects (n = 201) had a mean age of 70.8 ± 9.4 years, high stroke risk (CHA2DS2-VASc: 3.9 ± 1.7), elevated bleeding risk (HAS-BLED: 2.1 ± 1.2) with 53% patients from Asian countries. Successful implantation occurred in 98.5% of patients; 7-day device/procedure-related SAE rate was 3.0%. After 2 years of follow-up, the rates of ischaemic stroke/TIA/SE and major bleeding were 1.9 and 2.2 per 100-PY, respectively, representing relative reductions of 77% and 49% versus expected rates per risk scores. The relative risk reductions versus expected rates were more pronounced in Asians vs. Non-Asians (89% vs 62%; 77% vs 14%). Other significant findings included larger mean LAA ostium diameter for Asians vs. Non-Asians (23.4 ± 4.1 mm vs. 21.2 ± 3.2 mm, p < 0.001) and hence requirement for larger median device size (27 mm for Asians, 24 mm for non-Asians [p < 0.0001]). Conclusion: Real-world experience of left atrial appendage closure with WATCHMAN has demonstrated low peri-procedural risk, and long-term efficacy for stroke and bleeding prevention in a primarily Asian cohort.
dc.description.statementofresponsibilityKaren P. Phillips, Teguh Santoso, Prashanthan Sanders, Jeffrey Alison, Jason Leung Kwai Chan, Hui-Nam Pak, Mann Chandavimol, Kenneth M. Stein, Nicole Gordon, Omar Bin Razali
dc.identifier.citationInternational Journal of Cardiology: Heart & Vasculature, 2019; 23:100358-1-100358-6
dc.identifier.doi10.1016/j.ijcha.2019.100358
dc.identifier.issn2352-9067
dc.identifier.issn2352-9067
dc.identifier.orcidSanders, P. [0000-0003-3803-8429]
dc.identifier.urihttp://hdl.handle.net/2440/128721
dc.language.isoen
dc.publisherElsevier
dc.relation.grantNHMRC
dc.rights© 2019 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.source.urihttps://doi.org/10.1016/j.ijcha.2019.100358
dc.subjectAtrial fibrillation; ischaemic stroke; left atrial appendage; LAA device closure; anticoagulant therapy
dc.titleLeft atrial appendage closure with WATCHMAN in Asian patients: 2 year outcomes from the WASP registry
dc.typeJournal article
pubs.publication-statusPublished

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