Left Atrial Appendage Closure Is Associated With Reduced Bleeding, Stroke, And Mortality In Liver Cirrhosis

Abstract 2317249, presented at Western Atrial Fibrillation Symposium 2026

We hypothesize that percutaneous left atrial appendage closure (LAAC) is associated with lower risk of bleeding, stroke and mortality in patients with atrial fibrillation and liver cirrhosis compared to oral anticoagulants (OAC).Using the TriNetX Research Network, we identified adults with liver cirrhosis and AF divided by patients who received LAAC and patients who received OAC. We excluded patients with a history of bleeding or stroke. Propensity matching was conducted on age, sex, and other relevant comorbidities. Baseline characteristics were summarized and compared through Chi-square and Wilcoxon rank sum tests for categorical and continuous variables, respectively. Composite outcome of bleeding, stroke and mortality was analyzed and compared between the groups at 2 years.After propensity matching, 394 patients were identified in the LAAC group and 443 patients in the OAC group. Patients with LAAC had lower bleeding, stroke and mortality (Risk di"erence: -10.3%; 95% CI: -16.3 to -4.2%; p=0.001). Two-year event-free survival was 64.4% in the LAAC group and 59.0% in the OAC group (Hazard Ratio: 0.74; 95% CI: 0.37-0.96; p=0.02).LAAC is associated with lower risk of bleeding, stroke and mortality in patients with atrial fibrillation and liver cirrhosis compared to OAC.