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Apixaban with Antip...
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Alexander, John H.
(author)
Apixaban with Antiplatelet Therapy after Acute Coronary Syndrome
- Article/chapterEnglish2011
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LIBRIS-ID:oai:DiVA.org:uu-158588
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-158588URI
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https://doi.org/10.1056/NEJMoa1105819DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background: Apixaban, an oral, direct factor Xa inhibitor, may reduce the risk of recurrent ischemic events when added to antiplatelet therapy after an acute coronary syndrome.Methods: We conducted a randomized, double-blind, placebo-controlled clinical trial comparing apixaban, at a dose of 5 mg twice daily, with placebo, in addition to standard antiplatelet therapy, in patients with a recent acute coronary syndrome and at least two additional risk factors for recurrent ischemic events.Results: The trial was terminated prematurely after recruitment of 7392 patients because of an increase in major bleeding events with apixaban in the absence of a counterbalancing reduction in recurrent ischemic events. With a median follow-up of 241 days, the primary outcome of cardiovascular death, myocardial infarction, or ischemic stroke occurred in 279 of the 3705 patients (7.5%) assigned to apixaban (13.2 events per 100 patient-years) and in 293 of the 3687 patients (7.9%) assigned to placebo (14.0 events per 100 patient-years) (hazard ratio with apixaban, 0.95; 95% confidence interval [CI], 0.80 to 1.11; P = 0.51). The primary safety outcome of major bleeding according to the Thrombolysis in Myocardial Infarction (TIMI) definition occurred in 46 of the 3673 patients (1.3%) who received at least one dose of apixaban (2.4 events per 100 patient-years) and in 18 of the 3642 patients (0.5%) who received at least one dose of placebo (0.9 events per 100 patient-years) (hazard ratio with apixaban, 2.59; 95% CI, 1.50 to 4.46; P = 0.001). A greater number of intracranial and fatal bleeding events occurred with apixaban than with placebo.Conclusions: The addition of apixaban, at a dose of 5 mg twice daily, to antiplatelet therapy in high-risk patients after an acute coronary syndrome increased the number of major bleeding events without a significant reduction in recurrent ischemic events.
Added entries (persons, corporate bodies, meetings, titles ...)
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Lopes, Renato D.
(author)
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James, StefanUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)stjam367
(author)
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Kilaru, Rakhi
(author)
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He, Yaohua
(author)
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Mohan, Puneet
(author)
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Bhatt, Deepak L.
(author)
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Goodman, Shaun
(author)
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Verheugt, Freek W.
(author)
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Flather, Marcus
(author)
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Huber, Kurt
(author)
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Liaw, Danny
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Husted, Steen E.
(author)
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Lopez-Sendon, Jose
(author)
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De Caterina, Raffaele
(author)
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Jansky, Petr
(author)
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Darius, Harald
(author)
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Vinereanu, Dragos
(author)
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Cornel, Jan H.
(author)
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Cools, Frank
(author)
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Atar, Dan
(author)
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Luis Leiva-Pons, Jose
(author)
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Keltai, Matyas
(author)
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Ogawa, Hisao
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Pais, Prem
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Parkhomenko, Alexander
(author)
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Ruzyllo, Witold
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Diaz, Rafael
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White, Harvey
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Ruda, Mikhail
(author)
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Geraldes, Margarida
(author)
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Lawrence, Jack
(author)
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Harrington, Robert A.
(author)
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Wallentin, LarsUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
(author)
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Uppsala universitetUppsala kliniska forskningscentrum (UCR)
(creator_code:org_t)
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In:New England Journal of Medicine365:8, s. 699-7080028-47931533-4406
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Lopes, Renato D.
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James, Stefan
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Kilaru, Rakhi
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He, Yaohua
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Mohan, Puneet
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Bhatt, Deepak L.
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Goodman, Shaun
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Verheugt, Freek ...
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Flather, Marcus
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Huber, Kurt
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Liaw, Danny
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Husted, Steen E.
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Lopez-Sendon, Jo ...
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De Caterina, Raf ...
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Jansky, Petr
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Darius, Harald
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Vinereanu, Drago ...
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Cornel, Jan H.
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Cools, Frank
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Atar, Dan
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Luis Leiva-Pons, ...
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Keltai, Matyas
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Ogawa, Hisao
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Pais, Prem
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Parkhomenko, Ale ...
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Ruzyllo, Witold
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Diaz, Rafael
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White, Harvey
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Ruda, Mikhail
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