Abstract 15591: Gender-Specific Differences in Patients Underwent Left Atrial Appendage Closure - Results From the Coburg Laa Occlusion Register

BackgroundLeft atrial appendage closure (LAAC) is an established treatment strategy to reduce the risk of stroke in patients with non-valvular atrial fibrillation and contraindications for oral anticoagulation. Sex and gender specific differences are increasingly important for all cardiovascular diseases and therapeutic interventions.MethodsA total of 201 consecutive patients (115 male, 79.6±6.4 years) were enrolled in the register from October 2016 to March 2018. All patients underwent LAAC using the Watchman Device (Boston Scientific). EQ-5D questionnaire (covering Mobility, Self Care, Usual Activities, Pain/Discomfort, Anxiety/Depression and health state) was completed in all patients before and 3 months after implantation.ResultsWomen were significantly older (79.6±6.5 vs. 77.0±7.9; p=0.01) than men. Coronary artery disease (CAD) was more common in men (69.57% vs. 46.51%, p=0.001) while CHADS2-VASC-Score was higher in women (4.7 vs. 4.1, p=0.0009). Anatomy of LAA, procedural data and complication rate were comparable (Table 1). Success rate was comparable in men and women (96.2% vs. 98.8%, p=0.307). Women had a higher score for Anxiety/Depression (1.41 vs. 1.8; p=0.01) before implantation, while other parameters of EQ-5D were comparable. Three months after LAAC, women showed a significant improvement in mobility, self care and usual activities, while all scores remained stable for men. The score for anxiety/depression was comparable in both groups after LAAC. Self-care was significantly better in women after LAAC compared to men (Table 1). Women had a significant improvement in health state 3 months after implantation. (54±17vs. 63.4±20.5; p=0.03).ConclusionOur preliminary data show that LAAC is a safe and effective therapeutic option for both sexes. Remarkably is the significant improvement of mobility, self care, usual activities and the overall health state in female patients after LAAC compared to their male counterparts. These potential improvements, most likely caused by the discontinuation of OAC, should be considered in the indication, especially in female patients.