Hypoattenuation Thickening on CT Prognostic After Left Atrial Appendage Occlusion

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High-grade hypoattenuation thickening on follow-up CT after left atrial appendage occlusion associated with higher stroke risk

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Sept. 13, 2023 (HealthDay News) — For patients with atrial fibrillation undergoing left atrial appendage occlusion (LAAO), high-grade hypoattenuation thickening (HAT) at follow-up computed tomography (CT) is associated with higher stroke risk, according to a study published online Sept. 5 in Radiology.

Xavier Iriart, M.D., from Bordeaux University Foundation in France, and colleagues conducted a prospective study to examine the association of HAT grade at follow-up CT after LAAO with clinical characteristics and outcomes. Patients with atrial fibrillation who had a high risk for stroke and underwent LAAO at two French medical centers from January 2012 to November 2020 were included. Overall, 412 patients who underwent follow-up CT at a mean of 4.2 ± 1.7 months after LAAO were analyzed.

The researchers found that low- and high-grade HAT were depicted in 23.8 and 5.1 percent of participants, respectively. Higher odds of antithrombotic drug discontinuation during follow-up were seen in association with high-grade HAT (odds ratio, 9.5), while low-grade HAT was associated with reduced odds of persisting left atrial appendage patency (odds ratio, 0.46). Stroke occurred in 5.8 percent of participants during a median follow-up of 17 months; high-grade HAT was associated with stroke (hazard ratio, 4.6), but no association was seen for low-grade HAT.

“These findings support the introduction of unequivocal standardized CT criteria for HAT grading, with important implications for treatment regimen optimization after implantation,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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