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Management and clin...
Management and clinical outcomes in patients treated with apixaban versus warfarin undergoing procedures
- Article/chapterEnglish2014
Publisher, publication year, extent ...
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American Society of Hematology,2014
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-236294
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-236294URI
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https://doi.org/10.1182/blood-2014-08-595496DOI
Supplementary language notes
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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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Using data from ARISTOTLE, we describe the periprocedural management of anticoagulation and rates of subsequent clinical outcomes among patients chronically anticoagulated with warfarin or apixaban. We recorded whether (and for how long) anticoagulant therapy was interrupted pre-procedure; whether bridging therapy was used; and the proportion of patients who experienced important clinical outcomes during the 30 days post-procedure. Of 10,674 procedures performed during follow-up in 5924 patients, 9260 were included in this analysis. Anticoagulant treatment was not interrupted pre-procedure 37.5% of the time. During the 30 days post-procedure, stroke or systemic embolism occurred after 16/4624 (0.35%) procedures among apixaban-treated patients and 26/4530 (0.57%) procedures among warfarin-treated patients (OR 0.601; 95% CI 0.322–1.120). Major bleeding occurred in 74/4560 (1.62%) procedures in the apixaban arm and 86/4454 (1.93%) in the warfarin arm (OR 0.846; 95% CI 0.614–1.166). The risk of death was similar with apixaban (54/4624 [1.17%]) and warfarin (49/4530 [1.08%]) (OR 1.082; 95% CI 0.733–1.598). Among patients in ARISTOTLE, the 30-day post-procedure stroke, death, and major bleeding rates were low and similar in apixaban- and warfarin-treated patients, regardless of whether anticoagulation was stopped beforehand. Our findings suggest that many patients on chronic anticoagulation can safely undergo procedures; some will not require a pre-procedure interruption of anticoagulation. ARISTOTLE ClinicalTrials.gov number (NCT00412984).
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Alexander, John H
(author)
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Wallentin, LarsUppsala universitet,Kardiologi(Swepub:uu)larswall
(author)
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Wojdyla, Daniel M
(author)
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Thomas, Laine
(author)
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Hanna, Michael
(author)
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Al-Khatib, Sana M
(author)
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Dorian, Paul
(author)
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Ansell, Jack
(author)
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Commerford, Patrick
(author)
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Flaker, Greg
(author)
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Lanas, Fernando
(author)
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Vinereanu, Dragos
(author)
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Xavier, Denis
(author)
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Hylek, Elaine M
(author)
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Held, ClaesUppsala universitet,Kardiologi(Swepub:uu)clahe947
(author)
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Verheugt, Freek W A
(author)
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Granger, Christopher B
(author)
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Lopes, Renato D
(author)
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Uppsala universitetKardiologi
(creator_code:org_t)
Related titles
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In:Blood: American Society of Hematology124:25, s. 3692-36980006-49711528-0020
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Garcia, David
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Alexander, John ...
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Wallentin, Lars
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Wojdyla, Daniel ...
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Thomas, Laine
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Hanna, Michael
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Al-Khatib, Sana ...
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Dorian, Paul
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Ansell, Jack
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Commerford, Patr ...
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Flaker, Greg
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Lanas, Fernando
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Vinereanu, Drago ...
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Xavier, Denis
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Hylek, Elaine M
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Held, Claes
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Verheugt, Freek ...
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Granger, Christo ...
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Lopes, Renato D
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Blood
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Uppsala University