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To the Editor The study by Dr Reddy and colleagues1 reported the 3.8-year follow-up of the PROTECT AF trial that randomized patients with atrial fibrillation (AF) to receive percutaneous left atrial appendage (LAA) closure with the WATCHMAN device or warfarin. We had a number of questions and concerns about the study.
First, patients randomized to receive warfarin were older and more often had cardiovascular comorbidities and permanent AF than the patients randomized to receive the LAA closure. In Table 1 in the article, P values were missing, so it is unclear if these differences were statistically significant and may in part explain the higher mortality in the warfarin group.
Stöllberger C, Schneider B. Left Atrial Appendage Closure for Atrial Fibrillation. JAMA. 2015;313(10):1057. doi:10.1001/jama.2015.0682