Left atrial appendage closure or anticoagulation for atrial fibrillation (Registro nro. 22833)

000 -Cabecera
Campo de control interno 03414nam a2200373 4500
001 - Número de control
control field ESSALUD
005 - Fecha y hora de la última transacción
Campo de control 20260819163736.0
007 - Tipo material - Descripcion fisica - info general
Tipo material - Descripcion fisica - info general ta
008 - Elementos de Longitud Fija - Información General
Elementos de Longitud Fija - Información t pe ||||| |||| 00| 0 spa d
040 ## - Origen de la Catalogación
Origen de la Catalogación BMG
041 ## - Idioma
Idioma eng
100 ## - Autor
Autor Doshi, Shephal K.
Rol del Autor Autor
9 (RLIN) 54162
245 ## - Titulo
Titulo Left atrial appendage closure or anticoagulation for atrial fibrillation
300 ## - Páginas
Paginación páginas: 2083-2094
520 ## - Resumen
Resumen Background: For patients with atrial fibrillation, the use of oral anticoagulant therapy to prevent stroke is limited by the risk of bleeding. Left atrial appendage closure is considered for patients who are unsuitable candidates for long-term anticoagulation, but its role in patients who are eligible for anticoagulants has not been established. Methods: In this ongoing, prospective, international, randomized trial involving patients with atrial fibrillation who were suitable candidates for anticoagulation, we randomly assigned patients in a 1:1 ratio to receive either device-based left atrial appendage closure (device group) or non–vitamin K antagonist oral anticoagulant (NOAC) therapy (anticoagulation group). The primary efficacy end point — a composite of death from cardiovascular causes, stroke, or systemic embolism — was tested for noninferiority (noninferiority margin, 4.8 percentage points) after 3 years of follow-up. The primary safety end point, non–procedure-related bleeding, was tested for superiority. Results: Of the 3000 patients who underwent randomization, 1499 were assigned to the device group and 1501 to the anticoagulation group. The mean (±SD) age of the patients was 71.7±7.5 years, 31.9% of the patients were women, and the mean CHA2DS2-VASc score was 3.5±1.3. At 3 years, a primary efficacy end-point event had occurred in 81 patients (Kaplan–Meier estimate, 5.7%) in the device group and in 65 patients (Kaplan–Meier estimate, 4.8%) in the anticoagulation group (difference, 0.9 percentage points; 95% confidence interval [CI], −0.8 to 2.6; P<0.001 for noninferiority). Non–procedure-related bleeding occurred in 154 patients (Kaplan–Meier estimate, 10.9%) in the device group and in 260 patients (Kaplan–Meier estimate, 19.0%) in the anticoagulation group (hazard ratio, 0.55; 95% CI, 0.45 to 0.67; P<0.001 for superiority). Conclusions: Among patients with atrial fibrillation who were candidates for anticoagulation, device-based left atrial appendage closure was noninferior to NOAC therapy with respect to a composite of death from cardiovascular causes, stroke, or systemic embolism and was superior to NOAC therapy for non–procedure-related bleeding at 3 years.
650 ## - Temas - Descriptores
Temas - Descriptores ANTICOAGULACIÓN
9 (RLIN) 53834
650 ## - Temas - Descriptores
Temas - Descriptores TROMBOEMBOLISMO
9 (RLIN) 32218
650 ## - Temas - Descriptores
Temas - Descriptores ARRITMIAS
9 (RLIN) 53863
650 ## - Temas - Descriptores
Temas - Descriptores CARDIOLOGÍA
9 (RLIN) 11301
650 ## - Temas - Descriptores
Temas - Descriptores MARCAPASOS
9 (RLIN) 53864
650 ## - Temas - Descriptores
Temas - Descriptores DESFIBRILADORES
9 (RLIN) 53865
700 ## - Autor Personal
Autor Personal Kar, Saibal
9 (RLIN) 54163
700 ## - Autor Personal
Autor Personal Nair, Devi G.
9 (RLIN) 53867
700 ## - Autor Personal
Autor Personal Waggoner, Thomas
9 (RLIN) 54164
700 ## - Autor Personal
Autor Personal Agarwal, Himanshu
9 (RLIN) 54165
700 ## - Autor Personal
Autor Personal Moussavian, Mehran
9 (RLIN) 54166
700 ## - Autor Personal
Autor Personal Kashani, Amir
9 (RLIN) 54167
700 ## - Autor Personal
Autor Personal Oza, Saumil
9 (RLIN) 54168
700 ## - Autor Personal
Autor Personal Feldman, Leon
9 (RLIN) 54169
700 ## - Autor Personal
Autor Personal Sadhu, Ashish
9 (RLIN) 54170
700 ## - Autor Personal
Autor Personal DeLurgio, David
9 (RLIN) 54171
773 0# - Revista (Relacion con el numero)
Host Biblionumber 22717
Host Itemnumber 22648
Ciudad, Editorial Massachusetts NEJM Group
Codigo barras item/ejemplar NEJM011
Titulo de la Revista The New England Journal of Medicine
Número de control de registro ESSALUD
ISSN 0028-4793
942 ## - Elementos de Koha
Tipo de Documento Artículos
Fecha procesamiento 2026-08-19
Catalogador sqb

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