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Updated: Jun 23, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

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Published on: February 28, 2012

Stroke prevention.

Gregory Yh Lip1, Lalit Kalra

  • 1University Department of Medicine, City Hospital, Birmingham, UK.

BMJ Clinical Evidence
|May 19, 2009
PubMed
Summary
This summary is machine-generated.

Individuals with a history of stroke or transient ischemic attack (TIA) face high risks for vascular events. This review evaluates preventive treatments, including anticoagulants and antiplatelets, to reduce recurrent stroke risk.

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Last Updated: Jun 23, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Area of Science:

  • Cardiology
  • Neurology
  • Evidence-Based Medicine

Background:

  • Individuals with a history of stroke or transient ischemic attack (TIA) are at elevated risk for subsequent vascular events, including myocardial infarction and recurrent stroke.
  • Approximately 10% of individuals experience a recurrent stroke within the first year post-event, with a continued risk of 5% annually thereafter.

Purpose of the Study:

  • To systematically review the effectiveness and safety of various preventive interventions for individuals with a history of stroke or TIA.
  • To assess the impact of anticoagulant and antiplatelet therapies in patients with atrial fibrillation, with or without a prior history of stroke or TIA.

Main Methods:

  • A systematic review was conducted, searching major databases (Medline, Embase, Cochrane Library) up to September 2006.
  • Included studies comprised systematic reviews, randomized controlled trials (RCTs), and observational studies.
  • Harms alerts from regulatory agencies (FDA, MHRA) were also incorporated.

Main Results:

  • 120 systematic reviews, RCTs, and observational studies met the inclusion criteria.
  • A GRADE evaluation was performed to assess the quality of evidence for different interventions.
  • The review synthesized data on a wide range of preventive strategies.

Conclusions:

  • The review provides information on the effectiveness and safety of interventions such as alternative antiplatelet regimens, anticoagulation, aspirin, blood pressure reduction, carotid revascularization procedures, and cholesterol reduction.
  • Evidence for various blood pressure-lowering regimens and vitamin B supplements (including folate) was also presented.
  • The findings aim to inform clinical decision-making for secondary stroke prevention.