Your browser doesn't support javascript.
loading
Apixaban in Comparison With Warfarin in PatientsWith Atrial Fibrillation and Valvular Heart DiseaseFindings From the Apixaban for Reduction in Stroke and OtherThromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial
Avezum, Alvaro; Lopes, Renato D; Schulte, Phillip J; Granger, Christopher B; Alexander, John H; Fernando Lanas; Gersh, Bernard J; Hanna, Michael; Pais, Prem; Erol, Cetin; Diaz, Rafael; Bahit, M Cecilia; Bartunek, Jozef; De Caterina, Raffaele; Shinya Goto; Ruzyllo, Witold; Zhu, Jun.
Afiliação
  • Avezum, Alvaro; Instituto Dante Pazzanese de Cardiologia. São Paulo. BR
  • Lopes, Renato D; Duke Clinical Research Institute. Durham. US
  • Schulte, Phillip J; Duke Clinical Research Institute. Durham. US
  • Granger, Christopher B; Duke Clinical Research Institute. Durham. US
  • Alexander, John H; Duke Clinical Research Institute. Durham. US
  • Fernando Lanas; Universidad de La Frontera. Temuco. CL
  • Gersh, Bernard J; Mayo Clinic College of Medicine. Rochester. US
  • Hanna, Michael; Bristol Myers Squibb. Princeton. US
  • Pais, Prem; St. John s Medical College e Research Institute. Bangalore. IN
  • Erol, Cetin; Ankara University School of Medicine. Ankara. TR
  • Diaz, Rafael; Estudios Cardiológicos Latinoamérica. Rosario. AR
  • Bahit, M Cecilia; INECO Neurociencias Oroño. Rosario. AR
  • Bartunek, Jozef; OLV Hospital. Aalst. BE
  • De Caterina, Raffaele; G. d’Annunzio University, Chieti, Italy and Fondazione ToscanaG. Monasterio. Pisa. IT
  • Shinya Goto; Tokai University School of Medicine. Isehara. JP
  • Ruzyllo, Witold; National Institute of Cardiology. Varsóvia. PL
  • Zhu, Jun; Wai Hospital. Beijing. CN
Circulation ; 132(8): 624-632, 2015. ilus
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1062028
Biblioteca responsável: BR79.1
Localização: BR79.1
ABSTRACT
Apixaban is approved for the prevention of stroke and systemic embolism in patients with nonvalvular atrialfibrillation. However, the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation(ARISTOTLE) trial included a substantial number of patients with valvular heart disease and only excluded patients withclinically significant mitral stenosis or mechanical prosthetic heart valves.Methods and Results—We compared the effect of apixaban and warfarin on rates of stroke or systemic embolism, majorbleeding, and death in patients with and without moderate or severe valvular heart disease using Cox proportional hazardsmodeling. Of the 18 201 patients enrolled in ARISTOTLE, 4808 (26.4%) had a history of moderate or severe valvular heartdisease or previous valve surgery. Patients with valvular heart disease had higher rates of stroke or systemic embolismand bleeding than patients without valvular heart disease. There was no evidence of a differential effect of apixaban overwarfarin in patients with and without valvular heart disease in reducing stroke and systemic embolism (hazard ratio [HR],0.70; 95% confidence interval [CI], 0.51–0.97 and HR, 0.84; 95%, CI 0.67–1.04; interaction P=0.38), causing less majorbleeding (HR, 0.79; 95% CI, 0.61–1.04 and HR, 0.65; 95% CI, 0.55–0.77; interaction P=0.23), and reducing mortality(HR, 1.01; 95% CI, 0.84–1.22 and HR, 0.84; 95% CI, 0.73–0.96; interaction P=0.10).Conclusions—More than a quarter of the patients in ARISTOTLE with nonvalvular atrial fibrillation had moderate or severevalvular heart disease. There was no evidence of a differential effect of apixaban over warfarin in reducing stroke orsystemic embolism, causing less bleeding, and reducing death in patients with and without valvular heart disease.
Assuntos
Buscar no Google
Coleções: Bases de dados nacionais / Brasil Contexto em Saúde: Agenda de Saúde Sustentável para as Américas / ODS3 - Saúde e Bem-Estar / ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Objetivo 9: Redução de doenças não transmissíveis / Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis / Doença Cardiovascular / Doença Cerebrovascular Base de dados: Sec. Est. Saúde SP / SESSP-IDPCPROD Assunto principal: Fibrilação Atrial / Doenças Cardiovasculares / Inibidor de Coagulação do Lúpus / Acidente Vascular Cerebral Idioma: Inglês Revista: Circulation Ano de publicação: 2015 Tipo de documento: Artigo Instituição/País de afiliação: Ankara University School of Medicine/TR / Bristol Myers Squibb/US / Duke Clinical Research Institute/US / Estudios Cardiológicos Latinoamérica/AR / G. d’Annunzio University, Chieti, Italy and Fondazione ToscanaG. Monasterio/IT / INECO Neurociencias Oroño/AR / Instituto Dante Pazzanese de Cardiologia/BR / Mayo Clinic College of Medicine/US / National Institute of Cardiology/PL / OLV Hospital/BE
Buscar no Google
Coleções: Bases de dados nacionais / Brasil Contexto em Saúde: Agenda de Saúde Sustentável para as Américas / ODS3 - Saúde e Bem-Estar / ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis Problema de saúde: Objetivo 9: Redução de doenças não transmissíveis / Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis / Doença Cardiovascular / Doença Cerebrovascular Base de dados: Sec. Est. Saúde SP / SESSP-IDPCPROD Assunto principal: Fibrilação Atrial / Doenças Cardiovasculares / Inibidor de Coagulação do Lúpus / Acidente Vascular Cerebral Idioma: Inglês Revista: Circulation Ano de publicação: 2015 Tipo de documento: Artigo Instituição/País de afiliação: Ankara University School of Medicine/TR / Bristol Myers Squibb/US / Duke Clinical Research Institute/US / Estudios Cardiológicos Latinoamérica/AR / G. d’Annunzio University, Chieti, Italy and Fondazione ToscanaG. Monasterio/IT / INECO Neurociencias Oroño/AR / Instituto Dante Pazzanese de Cardiologia/BR / Mayo Clinic College of Medicine/US / National Institute of Cardiology/PL / OLV Hospital/BE
...