<div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1625853617" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{12}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Left atrial appendage<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">(LAA)<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">closure during open-heart surgery</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>is</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>only beneficial for high-risk patients</span><span class="NormalTextRun SCXW93348238 BCX0">, the<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">European<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">LAACS-2 trial<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">shows,</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">but this benefit is not restricted solely to AF.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1681531698" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{14}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">The results were presented Monday</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>in</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">a Hot Line session at<span> </span></span></span><span class="NormalTextRun SCXW93348238 BCX0">the<span> </span></span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">European Society of Cardiology (ESC) Congress<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">2026<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">in Munich, Germany,</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>by<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">Associate Professor</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>Dr</span><span class="NormalTextRun SCXW93348238 BCX0">.</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">Helena Dominguez,<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">MD, PhD<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW93348238 BCX0">Bispebjerg</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>University Hospital, Copenhagen, Denmark</span><span class="NormalTextRun SCXW93348238 BCX0">.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="745130742" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{16}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Closure of the LAA</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">i</span><span class="NormalTextRun SCXW93348238 BCX0">s</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>recommended<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">as an adjunct to oral anticoagulation<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">in</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>ESC guidelines for</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>open-heart surgery<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">in</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>atrial fibrillation<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">(AF)<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">patients to reduce stroke risk</span><span class="NormalTextRun SCXW93348238 BCX0">,<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">she</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>noted</span><span class="NormalTextRun SCXW93348238 BCX0">.<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">The<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">small, muscular cardiac pouch<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">is a known<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">common source of clotting in AF patients.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1104320733" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{18}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Results from the first<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">real-world<span> </span></span></span><a class="Hyperlink SCXW93348238 BCX0" href="https://pubmed.ncbi.nlm.nih.gov/29792215/" target="_blank" rel="noreferrer noopener"><span class="NormalTextRun SCXW93348238 BCX0" data-ccp-charstyle="Hyperlink">LAACS trial</span></a><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>over in 187 patients<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">treated between 2010 to 2016<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">suggested that LAA closure was associated with a lower stroke risk</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">regardless of AF presence</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">(</span><span class="NormalTextRun SCXW93348238 BCX0">10-year<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">risk of stroke/ TIA in<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">LAA closed vs open</span><span class="NormalTextRun SCXW93348238 BCX0">, hazard ratio [HR]: 0.</span><span class="NormalTextRun SCXW93348238 BCX0">62</span><span class="NormalTextRun SCXW93348238 BCX0">; 95% confidence interval [CI]: 0.</span><span class="NormalTextRun SCXW93348238 BCX0">27</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>to 1.</span><span class="NormalTextRun SCXW93348238 BCX0">43</span><span class="NormalTextRun SCXW93348238 BCX0">;<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">P = 0.</span><span class="NormalTextRun SCXW93348238 BCX0">267</span><span class="NormalTextRun SCXW93348238 BCX0">)</span><span class="NormalTextRun SCXW93348238 BCX0">,<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">Dr</span><span class="NormalTextRun SCXW93348238 BCX0">.</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>Dominguez</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>said</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>during her presentation</span><span class="NormalTextRun SCXW93348238 BCX0">.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1391001224" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{20}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">H</span><span class="NormalTextRun SCXW93348238 BCX0">owever,<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">she</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">stressed that<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">the<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">evidence<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">was still</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>lacking in patients without a known AF history</span><span class="NormalTextRun SCXW93348238 BCX0">.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="177402312" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{22}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">The current</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>“much larger”</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">LAACS-2<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">study</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>therefore</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>set out to investigate whether the benefits of LAA closure could be<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">generalised to all open-heart surgery subjects. </span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1464916174" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{24}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">A total 1,500 patients were randomized 1:1<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">to either<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">concomitant LAA closure<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">(</span><span class="NormalTextRun SCXW93348238 BCX0">number completed = 703</span><span class="NormalTextRun SCXW93348238 BCX0">)<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">or standard care (open LAA</span><span class="NormalTextRun SCXW93348238 BCX0">, n</span><span class="NormalTextRun SCXW93348238 BCX0">umber completed</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>= 7</span><span class="NormalTextRun SCXW93348238 BCX0">11</span><span class="NormalTextRun SCXW93348238 BCX0">)</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>across four sites in Denmark,<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">Spain</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>and Sweden. </span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1033626781" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{26}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">AF was present in 4.4% of the closed group vs 3.9% of the open cohort.<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">Those<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">undergoing first-time planned open-heart surgery without AF</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">and those with<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">a previous</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>diagnosis of paroxysmal or chronic AF</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">were included.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="419224355" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{28}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">A total 90.5% of the closure group had LAA successfully closed</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>(71 did not due to technical or logistic challenges) while 99% of the control group had no closure (5</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>AF</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>patients</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>underwent LAA closure after surgeons were “reluctant”).</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>In the closure group 44 died, while 41 died in the control group and 1 was lost to follow-up</span><span class="NormalTextRun SCXW93348238 BCX0">.</span><span class="NormalTextRun SCXW93348238 BCX0"> </span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="283372562" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{30}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">The patients’ m</span><span class="NormalTextRun SCXW93348238 BCX0">ean age at baseline was 67 years and 18.5% were female, while<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">4.1% had AF, 6.1% had prior stroke and 2.5% had<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">previously suffered a<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">transient ischaemic attack</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>(TIA).</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">Mean</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">CHA</span></span><span class="NormalTextRun Subscript SCXW93348238 BCX0" data-fontsize="11">2</span><span class="NormalTextRun SCXW93348238 BCX0">DS</span><span class="NormalTextRun Subscript SCXW93348238 BCX0" data-fontsize="11">2</span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">-VASc</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>scores were<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">3 in both groups, mean left ventricular ejection fraction (LVEF) was 60% in both groups and<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">estimated glomerular filtration rate</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>(eGFR) was a mean of 83 ml/min/1.73m</span></span><span class="NormalTextRun Superscript SCXW93348238 BCX0" data-fontsize="11">2</span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span> </span><span class="NormalTextRun SCXW93348238 BCX0">in the LAA closure cohort vs<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">84</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>ml/min/1.73m</span></span><span class="NormalTextRun Superscript SCXW93348238 BCX0" data-fontsize="11">2</span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span> </span><span class="NormalTextRun SCXW93348238 BCX0">in the open group.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1102820660" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{32}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Planned procedures included<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">c</span><span class="NormalTextRun SCXW93348238 BCX0">oronary<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">a</span><span class="NormalTextRun SCXW93348238 BCX0">rtery<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">b</span><span class="NormalTextRun SCXW93348238 BCX0">ypass<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">g</span><span class="NormalTextRun SCXW93348238 BCX0">raft (CABG)</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>in 445 closed patients (59.6%) vs 449 open patients (59.6%)</span><span class="NormalTextRun SCXW93348238 BCX0">, mitral valve in 56 vs 58 respectively (7.5% vs 7.7%) or aortic valve with</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>(226 or 30.3% vs 224 or 29.8%</span><span class="NormalTextRun SCXW93348238 BCX0">)</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>or without CABG<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">(20 or 2.7% vs 22<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">or<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">2.</span><span class="NormalTextRun SCXW93348238 BCX0">9%).</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1010069305" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{34}"><strong><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun MacChromeBold SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">A closer look for all r</span><span class="NormalTextRun SCXW93348238 BCX0">aised stroke risk patients</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="2029065980" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{36}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Across a median 4-year follow-up, t</span><span class="NormalTextRun SCXW93348238 BCX0">here was no significant di</span><span class="NormalTextRun SCXW93348238 BCX0">ff</span><span class="NormalTextRun SCXW93348238 BCX0">erence in the primary outcome of stroke or<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">TIA<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">with LAA closure vs. standard care (4.28% vs. 5.04%, respectively</span><span class="NormalTextRun SCXW93348238 BCX0">, HR:<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">0.85; 95%<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">CI:</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>0.53 to 1.37;<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">P<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">=</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">0.517).</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="486086138" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{38}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">“Our results do not support routine LAA closure in all patients undergoing planned cardiac surgery</span><span class="NormalTextRun SCXW93348238 BCX0">,” Dr</span><span class="NormalTextRun SCXW93348238 BCX0">.</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>Dominguez concluded.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1042738190" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{40}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Still, she stressed</span><span class="NormalTextRun SCXW93348238 BCX0">,</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>“</span><span class="NormalTextRun SCXW93348238 BCX0">Patients undergoing heart surgery at high stroke risk may avoid a disabling stroke if their LAA is closed</span><span class="NormalTextRun SCXW93348238 BCX0">.”</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1404591876" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{42}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Dr</span><span class="NormalTextRun SCXW93348238 BCX0">.</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>Dominguez went on to note</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>that<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">interventionalists should consider concomitant LAA closure in patients with elevated thromboembolic risk<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">independent of AF diagnosis</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>and suggested that guidelines should be changed to reflect this. </span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="930788334" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{44}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">Notably,<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">patients who had the highest stroke risk at baseline (CHA</span></span><span class="NormalTextRun Subscript SCXW93348238 BCX0" data-fontsize="11">2</span><span class="NormalTextRun SCXW93348238 BCX0">DS</span><span class="NormalTextRun Subscript SCXW93348238 BCX0" data-fontsize="11">2</span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">-VASc score above the median) had a 56% reduction in the primary endpoint with LAA closure (</span><span class="NormalTextRun SCXW93348238 BCX0">HR: 0.44; 95% CI: 0.22 to 0.90;<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">P<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">=</span><span> </span><span class="NormalTextRun SCXW93348238 BCX0">0.018),<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">while</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>no significant benefit was observed in those with lower stroke risk</span><span class="NormalTextRun SCXW93348238 BCX0">.</span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="2111978540" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{47}"><span class="NormalTextRun SCXW93348238 BCX0">Long-term follow-up of patients in the study is ongoing.</span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1495145589" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{49}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0">“As we saw in the LAACS trial, the primary endpoint curves diverged over time in LAACS-2 and follow-up will be continued</span><span class="NormalTextRun SCXW93348238 BCX0">,</span><span class="NormalTextRun SCXW93348238 BCX0">”</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>Dr</span><span class="NormalTextRun SCXW93348238 BCX0">.</span><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>Dominguez said.</span><span class="NormalTextRun SCXW93348238 BCX0"> </span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" paraid="1148894285" paraeid="{215e7761-d820-41b1-a0d7-7658fa0b0833}{51}"><span class="NormalTextRun SCXW93348238 BCX0">A<span> </span></span><a class="Hyperlink SCXW93348238 BCX0" href="https://clinicaltrials.gov/study/NCT06405750" target="_blank" rel="noreferrer noopener"><span class="NormalTextRun SCXW93348238 BCX0" data-ccp-charstyle="Hyperlink">mechanistic study</span></a><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW93348238 BCX0"><span class="NormalTextRun SCXW93348238 BCX0"><span> </span>is now ongoing with the<span> </span></span><span class="NormalTextRun SCXW93348238 BCX0">aim to further understand stroke risk following LAA closure in patients undergoing open-heart surgery. </span></span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" lang="EN-US" paraid="2106218791" paraeid="{ca156984-3e61-42c7-9350-1f2bbda11549}{48}"><strong><span class="NormalTextRun SCXW93348238 BCX0">Image Credit: European Society of Cardiology 2026. </span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW93348238 BCX0"> <p class="Paragraph SCXW93348238 BCX0" lang="EN-US" paraid="1225726394" paraeid="{ca156984-3e61-42c7-9350-1f2bbda11549}{55}"><strong><span class="NormalTextRun SCXW93348238 BCX0">Image Caption: Entrance to the conference hall at the European Society of Cardiology (ESC) Congress 2026 in Munich, Germany.</span><span class="EOP Selected SCXW93348238 BCX0" data-ccp-props="{}"> </span></strong></p> </div>