Wonderful article! What do you think of the “Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients With Elevated CHA2DS2-VASc Score: Results of the Randomized ATLAS Trial”?
Is there a benefit of prophylactic LAAO in patients at risk of Afib?
Thanks for this very interesting piece - it spurred me to look at the pdf presentation of the results by the trial team.
However, the pdf's joyfully positive spin on the results made me wish for a more sober analysis, particularly of the post-surgery events in the two groups.
For example, since the 4800 patients were spread out over so many countries, were there any country patterns or skews detected regarding the events? Were there any patterns regarding patients' past medical histories? Since the death rates were identical in the two groups, were the actual causes of death also largely identical? Were the average ages at death the same? Were there any skews regarding deaths in different countries?
Still, I saw a comment by Dr. Gani who wondered whether the identical mortality rates didn't tend to reduce the clinical relevance of the trial, unless it was demonstrated that quality of life was measurably improved. This seems a reasonable question regarding any intervention in elderly patients.
Didn't read the whole NEJM study though, so maybe some of these questions were addressed.
Wonderful article! What do you think of the “Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients With Elevated CHA2DS2-VASc Score: Results of the Randomized ATLAS Trial”?
Is there a benefit of prophylactic LAAO in patients at risk of Afib?
Love this content!
Thanks for this very interesting piece - it spurred me to look at the pdf presentation of the results by the trial team.
However, the pdf's joyfully positive spin on the results made me wish for a more sober analysis, particularly of the post-surgery events in the two groups.
For example, since the 4800 patients were spread out over so many countries, were there any country patterns or skews detected regarding the events? Were there any patterns regarding patients' past medical histories? Since the death rates were identical in the two groups, were the actual causes of death also largely identical? Were the average ages at death the same? Were there any skews regarding deaths in different countries?
Still, I saw a comment by Dr. Gani who wondered whether the identical mortality rates didn't tend to reduce the clinical relevance of the trial, unless it was demonstrated that quality of life was measurably improved. This seems a reasonable question regarding any intervention in elderly patients.
Didn't read the whole NEJM study though, so maybe some of these questions were addressed.