Publications by authors named "Chengan Du"
Association of Physician Certification and Outcomes Among Patients Undergoing Left Atrial Appendage Occlusion.
JACC Cardiovasc Interv
March 2025
Article Synopsis
- The study examines outcomes of percutaneous left atrial appendage occlusion (LAAO) procedures performed by either electrophysiologists (EPs) or interventional cardiologists (ICs) between 2020 and 2022, focusing on patient safety and complications.
- Key findings indicate that EPs utilized intracardiac echocardiography more frequently and achieved lower radiation exposure; however, rates of major adverse events (MAE) and in-hospital mortality were comparable between the two groups.
- Overall, LAAO was deemed safe with no significant differences in outcomes based on operator certification, highlighting the importance of continued use of these techniques by both specialties for broader patient access.
Article Synopsis
- The research highlights significant racial and ethnic disparities in excess mortality during the COVID-19 pandemic, revealing a concerning trend concerning minoritized populations who faced greater mortality rates compared to pre-pandemic disparities.!* -
- A comprehensive analysis of over 10.6 million death certificates from March 2020 to May 2023 indicated that more than 1.38 million excess deaths occurred, representing around 23 million years of potential life lost.!* -
- The findings emphasize the need for further investigation into the age-specific impact of COVID-19 on various racial and ethnic groups to better understand and address these health disparities moving forward.!*
Procedure Volume and Outcomes With WATCHMAN Left Atrial Appendage Occlusion.
Circ Cardiovasc Interv
June 2024
Article Synopsis
- Higher hospital and physician volumes of WATCHMAN left atrial appendage occlusion procedures correlate with better procedural success, indicating that experience may influence outcomes.
- An analysis of over 87,000 patients revealed a 94.2% success rate overall, with lower success rates seen in lower-volume hospitals and physicians.
- The newer WATCHMAN FLX device showed improved success rates and reduced variability in outcomes across different volume categories compared to earlier models.
Article Synopsis
- Researchers wanted to see if adding extra treatments during heart procedures (besides the usual one) caused more problems for patients with heart issues called atrial fibrillation (AF).
- They looked at a lot of patients (over 50,000) and compared those who just had the usual treatment to those who had extra treatments.
- They found that while extra treatments didn’t cause more problems for some patients, there was a higher chance of complications for certain patients with more serious heart issues.
Background: The National Cardiovascular Data Registry (NCDR) AFib Ablation Registry was created to assess real-world prevalence, demographic characteristics, procedural management, and outcomes of patients undergoing atrial fibrillation (AF) ablation procedures.
Objectives: The goal of this study was to characterize the patient, hospital, and physician characteristics and in-hospital outcomes related to AF ablation in the first 5 years of the registry.
Methods: This paper describes the AFib Ablation Registry structure and governance, outcome assessment processes, data quality, and data collection processes.
Device-Sizing and Associated Complications With Left Atrial Appendage Occlusion: Findings From the NCDR LAAO Registry.
Circ Cardiovasc Interv
December 2022
Article Synopsis
- Left atrial appendage occlusion is a viable alternative to anticoagulation for patients with nonvalvular atrial fibrillation, yet device sizing and complications in real-world use needed further analysis.
- A study using the NCDR LAAO Registry examined the outcomes of patients receiving Watchman 2.5 devices, categorizing them as undersized, oversized, or per manufacturer recommendations.
- Findings revealed that a significant portion of patients received oversized devices, which were associated with lower odds of complications like leakage compared to manufacturers' sizing, and the preference for oversized devices increased over the study period.
Comparative Safety of Transcatheter LAAO With the First-Generation Watchman and Next-Generation Watchman FLX Devices.
JACC Cardiovasc Interv
November 2022
Background: Procedural complications limit the clinical benefit of transcatheter left atrial appendage occlusion (LAAO). Next-generation devices incorporate design modifications intended to improve procedural safety, but their clinical impact has not been described.
Objectives: The aim of this study was to compare in-hospital outcomes for the Watchman FLX with the predicate Watchman 2.
Article Synopsis
- The study aims to introduce a new way to measure disparities at the hospital level by focusing on continuous polysocial risk factors and their impact on patient outcomes.
- It analyzed Medicare data for patients aged 65 and older, focusing on hospital readmissions for common conditions, using methods that improve upon traditional measurements of social risk.
- The results suggest that this novel approach provides a more nuanced understanding of disparities across hospitals and helps identify provider-level outcomes that better reflect social risk profiles.
Article Synopsis
- This study investigated the impact of female sex on outcomes after catheter ablation for atrial fibrillation, analyzing data from nearly 59,000 adults enrolled in a national registry.
- Results showed that women were generally older, had more health issues, and reported lower quality of life related to atrial fibrillation than men.
- Women faced higher risks of hospitalization, major adverse events, and specific complications, but there were no differences in mortality rates or success in isolating pulmonary veins.
Indications for Left Atrial Appendage Occlusion in the United States and Associated In-Hospital Outcomes: Results From the NCDR LAAO Registry.
Circ Cardiovasc Qual Outcomes
August 2022
Background: The Food and Drug Administration approved left atrial appendage occlusion with the Watchman device for patients who are at increased stroke risk and are suitable for oral anticoagulation but who have an appropriate reason to seek a nondrug alternative. These broad criteria raise the question of their interpretation in clinical practice. There is a lack of studies comprehensively evaluating the indications for Watchman implantation among a large series of patients from contemporary, real-world practice in the United States.
View Article and Find Full Text PDFThis modeling study estimates the excess deaths attributable to COVID-19 disease in Massachusetts during the Delta (June to December 2021) and Omicron (December 2021 to February 2022) waves.
View Article and Find Full Text PDFPatient-Level Analysis of Watchman Left Atrial Appendage Occlusion in Practice Versus Clinical Trials.
JACC Cardiovasc Interv
May 2022
Objectives: The aim of this study was to compare outcomes among patients from the PROTECT-AF (WATCHMAN Left Atrial Appendage System for Embolic PROTECTion in Patients With Atrial Fibrillation) and PREVAIL (Evaluation of the WATCHMAN Left Atrial Appendage [LAA] Closure Device in Patients With Atrial Fibrillation Versus Long Term Warfarin Therapy) left atrial appendage occlusion (LAAO) trials with matched patients from the National Cardiovascular Data Registry LAAO Registry using patient-level data.
Background: Patients undergoing LAAO in clinical practice generally have more comorbidities than trial participants.
Methods: Propensity-matched analyses, with up to 3 registry patients matched to each trial patient, were performed using Cox proportional hazards and Fine-Gray models.
Article Synopsis
- A study analyzed postprocedure care for patients who underwent left atrial appendage occlusion (LAAO) using the Watchman device between 2016 and 2018, focusing on adherence to established treatment protocols.
- Results showed that only 12.2% of the 31,994 patients received the full treatment protocols, with common discrepancies found in discharge antithrombotic medications.
- Additionally, compared with those discharged on warfarin and aspirin, patients receiving just warfarin or direct oral anticoagulants (DOAC) had significantly lower risks of adverse events at both 45 days and 6 months post-procedure.
Clinical Outcomes at 1 Year Following Transcatheter Left Atrial Appendage Occlusion in the United States.
JACC Cardiovasc Interv
April 2022
Objectives: The aim of this study was to report 1-year clinical outcomes following commercial transcatheter left atrial appendage occlusion (LAAO) in the United States.
Background: The National Cardiovascular Data Registry LAAO Registry was initiated to meet a condition of Medicare coverage and allow the assessment of clinical outcomes. The 1-year rates of thromboembolic events after transcatheter LAAO in such a large cohort of "real-world" patients have not been previously reported.
Clinical Impact of Residual Leaks Following Left Atrial Appendage Occlusion: Insights From the NCDR LAAO Registry.
JACC Clin Electrophysiol
June 2022
Background: Data on the impact of residual peri-device leak after left atrial appendage occlusion (LAAO) are limited.
Objectives: The goal of this study was to explore the association of peri-device leak with adverse clinical events.
Methods: The National Cardiovascular Data Registry LAAO Registry was queried to identify patients undergoing LAAO between January 1, 2016, and December 31, 2019.
This cohort study examines mortality data from Texas, a racially and ethnically diverse state, to better understand excess mortality among adults aged 25 to 44 years during early months of the COVID-19 pandemic.
View Article and Find Full Text PDFThis cross-sectional ecological study examines the association between publicly reported hospital performance scores in Hospital Care Compare and hospital market share.
View Article and Find Full Text PDFNew Metrics for Assessing the State Performance in Combating the COVID-19 Pandemic.
Geohealth
September 2021
Previous research has noted that many factors greatly influence the spread of COVID-19. Contrary to explicit factors that are measurable, such as population density, number of medical staff, and the daily test rate, many factors are not directly observable, for instance, culture differences and attitudes toward the disease, which may introduce unobserved heterogeneity. Most contemporary COVID-19 related research has focused on modeling the relationship between explicitly measurable factors and the response variable of interest (such as the infection rate or the death rate).
View Article and Find Full Text PDFDisparities in Excess Mortality Associated with COVID-19 - United States, 2020.
MMWR Morb Mortal Wkly Rep
August 2021
The COVID-19 pandemic has disproportionately affected Hispanic or Latino, non-Hispanic Black (Black), non-Hispanic American Indian or Alaska Native (AI/AN), and non-Hispanic Native Hawaiian or Other Pacific Islander (NH/PI) populations in the United States. These populations have experienced higher rates of infection and mortality compared with the non-Hispanic White (White) population (1-5) and greater excess mortality (i.e.
View Article and Find Full Text PDFImportance: Left atrial appendage occlusion (LAAO) has emerged as an alternative to anticoagulation for select patients with atrial fibrillation; however, women have been underrepresented in clinical trials of LAAO, and sex-specific subanalyses are limited.
Objective: To evaluate the sex differences in the baseline characteristics of patients undergoing LAAO implant and in the in-hospital outcomes after LAAO implant.
Design, Setting, And Participants: A total of 49 357 patients in the National Cardiovascular Data Registry LAAO Registry undergoing LAAO with the Watchman device between January 1, 2016, and June 30, 2019, were included in this study.