Michel Cabrera Ortega: LAAC vs OAC – Which Risk Are We Trading?
Michel Cabrera Ortega, Cardiologist at Saint John of God Sanitary Park, shared a post on LinkedIn:
“LAAC vs OAC: Which risk are we trading?
Left atrial appendage closure is increasingly discussed as an alternative to long-term oral anticoagulation for stroke prevention in atrial fibrillation.
But recent randomized evidence reminds us that the comparison is more complex than ‘procedure versus medication.’
Overall stroke and major bleeding may be broadly similar, yet the type and timing of events differ: LAAC may reduce later nonprocedural bleeding, while potentially increasing ischemic stroke and introducing an upfront procedural risk.
So perhaps the most relevant question is not simply:
- Which strategy is better?
But rather:
- Which risk are we willing to accept for this particular patient?
LAAC should not be viewed as a universal substitute for anticoagulation, but as a different strategy with a different balance of risks.
Is LAAC ready to become first-line therapy in anticoagulation-eligible patients – or should patient selection remain the key?”
Jorge Enrique Aguiar Perez, Cardiologist at the Institute of Cardiology, shared this post on LinkedIn, adding:
“Excellent perspective.
LAAC should not be seen simply as a replacement for oral anticoagulation, but as a different risk–benefit strategy.
The key remains individualized patient selection and shared decision-making.
An important and timely discussion.”
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