Safety and Effectiveness of Short-Term Single AntiPlatelet Therapy After Left Atrial Appendage Closure With the LAmbre Device in Patients With Nonvalvular Atrial Fibrillation: A Multinational Real-world Registry

Launched by FUNDACIÓN EPIC · Sep 27, 2024

Keywords

ClinConnect Summary

This clinical trial is studying the safety and effectiveness of a short-term treatment using a single type of blood-thinning medication, called antiplatelet therapy, for patients who have undergone a procedure to close a part of the heart called the left atrial appendage. This is specifically for individuals with a heart condition known as nonvalvular atrial fibrillation, who cannot take long-term blood thinners due to other health reasons. The trial will involve giving participants either aspirin or clopidogrel for three months after their procedure to see how well it works and whether it is safe.

To be eligible, participants must be at least 18 years old, have nonvalvular atrial fibrillation, and have a specific score that indicates their risk for stroke. They should also have had a successful left atrial appendage closure procedure without complications and be willing to attend follow-up visits. Throughout the study, participants will take their assigned medication daily and will be monitored for any side effects or issues over 12 months. This trial is important because it aims to find a suitable treatment option for patients who cannot use longer-term anticoagulant medications while still managing their risk of stroke.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • All criteria must be met
• • Patient 18 years and over and
• • Patient with documented nonvalvular AF, defined as AF in the absence of moderate or severe mitral stenosis or a mechanical heart valve and
• • Patient with a calculated CHA₂DS₂-VASc score ≥2 (for men) and ≥3 (for women) and
• • Patient with a contraindication for long-term anticoagulant treatment and
• • Patient who has undergone a successful LAmbre LAAC device implantation with no complications during the in-hospital period after the intervention and
• • Patient able and willing to return for required follow-up visits and examinations and
• • Patient with Informed consent signed.
• Exclusion Criteria:
• • No exclusion criteria must be met.
• • Patient is currently enrolled in another investigational study, except when the subject is participating in a purely observational registry with no associated treatments.
• • Patient requires long-term anticoagulation therapy for reasons other than AFrelated stroke risk reduction, for example, due to an underlying hypercoagulable state (i.e even if the device is implanted, the subjects would not be eligible to discontinue OAC (Oral Anticoagulation) due to other medical conditions requiring chronic OAC therapy).
• • Patient has contraindications or is allergic to both aspirin and clopidogrel.
• • Patient has an indication for chronic aspirin or clopidogrel treatment (i.e., chronic ischemic disease or peripheral artery disease); thus, the subject would not be eligible to discontinue aspirin or clopidogrel due to other medical conditions requiring this therapy.
• • Patient had or is planning to have any cardiac or noncardiac intervention or surgical procedure within 30 days before or 60 days after implant (including, but not limited to: cardioversion, PCI (Percutaneous Coronary Intervention), cardiac ablation, cataract surgery, etc.).
• • Patient had a prior stroke (of any cause, whether ischemic or hemorrhagic) or transient ischemic attack (TIA) within the 30 days prior to enrollment.
• • Patient had a major bleeding event within the 30 days prior to inclusion. Lack of resolution of related clinical sequelae or planned and pending interventions to resolve bleeding/bleeding source are further exclusions, regardless of the timing of the bleeding event.
• • Patient has an active bleeding.
• • Patient has had an MI documented in the clinical record as either a NSTEMI or STEMI, with or without intervention, within 30 days prior to enrollment.
• • Patient has a history of atrial septal repair or has an ASD/PFO device.
• • Patient is of childbearing potential, or plans to become pregnant during the study (method of assessment upon study physician's discretion).
• • Patient had subject has a documented life expectancy of less than one year.