How to estimate the potential clinical benefit associated with left atrial appendage closure? Authors ’ reply

In response to the letter by Fauchier et al.,1 we wish to highlight numerous erroneous statements they have made with regards the data and analysis in our published article2 Firstly Fauchieret al. claim that ‘8% of patients still had oral anticoagulation (OAC) at 2-year follow-up, with no information on OAC use in the preceding follow-up visits’. However, the article states that 94% of patients stopped OAC at the first follow-up visit (2–3 months post-procedure) and patients who were recommenced on OAC during follow-up are individually described in the results leading to 8% of patients taking OAC at the end of 2-year follow-up.2 Furthermore, they make exaggerated claims that ‘the theoretical rate of stroke in this work was overestimated because (i) many patients received a significant duration of OAC instead of no OAC’. The data, however, clearly outlines that more than 90% of patients were not taking OAC for at least 21 months of the 24-month follow-up which nega tes this suggestion. Lastly, Fauchieret al. have attempted to misrepresent the analysis for stroke risk reduction claiming ‘these assumptions used the worst-case scenario (risk of stroke with no OAC […]) which does not apply to the study’ and ‘It is thus very likely that the theoretical rate of stroke in this work was overestimated because […] more than 80% of patients were treated with antiplatelet therapy at 2-year follow-up’. However, our results stipulate ‘The expected rate of ischaem...
Source: Europace - Category: Cardiology Source Type: research