Stroke Clinical Trial
Official title:
The WASPS Trails:WATCHMAN for Second Prevention of Stroke
To evaluate the effects of mechanical left atrial appendage (LAA) closure for secondary prevention of stroke in the patients with nonvalvular atrial fibrillation
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting an
estimated 5 million Chinese. Atrial fibrillation is the primary cardiac abnormality
associated with embolic stroke; among patients with AF, there is an annual stroke rate, about
5 times for the same age population in sinus rhythm.
Although warfarin therapy is effective at reducing the risk of stroke, chronic
anticoagulation presents problems of safety and acceptability for many patients. Drug and
dietary interactions, frequent blood tests, and compliance issues all contribute to
difficulties with chronic warfarin therapy. New oral anticoagulant compounds with better
therapeutic range and without need for similar monitoring, such as Dabigatran, Rivaroxaban,
Apixaban and Edoxaban,have been studied, but there is no direct comparison with left atrial
appendage closure(LAAC).
However,the left atrial appendage (LAA) is the major location of thrombi in patients with AF.
In patients with nonrheumatic AF and thrombus in the left atrium, the clot was located in the
LAA in 90%. And the WATCHMAN Left Atrial Appendage System is a novel device designed to
prevent the embolization of thrombi that may form in the LAA. It is hypothesized that it may
prevent ischemic stroke and systemic thromboembolism in patients with AF.The PROTECT-Af and
PREVAIL trails confirmed this device's efficacy and safety, compared with warfarin, for
preventing the combined outcome of stroke,systemic embolism, and cardiovascular death. And
the device has been approved by China's FDA.
Stroke is the primary cause of death in China, and recurrence of stroke remains a major
public health issue.
This cohort study is designed to evaluate the effects of mechanical left atrial appendage
(LAA) closure for secondary prevention of ischemic stroke in the patients with nonvalvular
atrial fibrillation in China, compared with medicine approach (Warfarin or NOAC),.
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