William Cadden: Risk–Benefit Considerations in Atrial Fibrillation
William Cadden, Director of Medical Device Partnerships at Radcliffe Group, shared a post on LinkedIn:
“At ACC26, Dr Devi G Nair and Dr Vivek Reddy discussed the implications of the late-breaking CHAMPION-AF data, focusing on a central clinical question: how should we weigh stroke risk against bleeding reduction?
The data suggest a modest absolute increase in ischaemic stroke and systemic embolism with a device-based strategy, offset by a substantial reduction in clinically relevant bleeding.
Interpreting this balance is not straightforward and depends on how different endpoints are valued in practice.
A key part of the discussion explored whether all bleeding events should be considered equal, particularly when ‘clinically relevant non-major’ bleeding is included alongside more severe outcomes.
Similarly, the role of procedure-related complications within composite endpoints remains an important consideration when assessing overall benefit.
Ultimately, the conversation reinforces that this is not a one-size-fits-all decision.
The relative importance of stroke prevention versus bleeding avoidance will vary between patients, and careful selection remains essential when considering first-line left atrial appendage closure versus continued anticoagulation.
As longer-term follow-up becomes available, these trade-offs will become clearer and further inform clinical decision-making.”
Proceed to the video attached to the post.
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