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Sökning: onr:"swepub:oai:DiVA.org:uu-374972" > Outcomes of apixaba...

  • Alexander, Karen P (författare)

Outcomes of apixaban versus warfarin in patients with atrial fibrillation and multi-morbidity : Insights from the ARISTOTLE trial

  • Artikel/kapitelEngelska2019

Förlag, utgivningsår, omfång ...

  • Elsevier BV,2019
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-374972
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-374972URI
  • https://doi.org/10.1016/j.ahj.2018.09.017DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Patients with atrial fibrillation (AF) often have multi-morbidity, defined as ≥3 comorbid conditions. Multi-morbidity is associated with polypharmacy, adverse events, and frailty potentially altering response to anticoagulation. We sought to describe the prevalence of multi-morbidity among older patients with AF and determine the association between multi-morbidity, clinical outcomes, and the efficacy and safety of apixaban compared with warfarin.METHODS: In this post-hoc subgroup analysis of the ARISTOTLE trial, we studied enrolled patients age ≥ 55 years (n = 16,800). Patients were categorized by the number of comorbid conditions at baseline: no multi-morbidity (0-2 comorbid conditions), moderate multi-morbidity (3-5 comorbid conditions), and high multi-morbidity (≥6 comorbid conditions). Association between multi-morbidity and clinical outcomes were analyzed by treatment with a median follow-up of 1.8 (1.3-2.3) years.RESULTS: Multi-morbidity was present in 64% (n = 10,713) of patients; 51% (n = 8491) had moderate multi-morbidity, 13% (n = 2222) had high multi-morbidity, and 36% (n = 6087) had no multi-morbidity. Compared with the no multi-morbidity group, the high multi-morbidity group was older (74 vs 69 years), took twice as many medications (10 vs 5), and had higher CHA2DS2-VASc scores (4.9 vs 2.7) (all P < .001). Adjusted rates per 100 patient-years for stroke/systemic embolism, death, and major bleeding increased with multi-morbidity (Reference no multi-morbidity; moderate multi-morbidity 1.42 [1.24-1.64] and high multi-morbidity 1.92 [1.59-2.31]), with no interaction in relation to efficacy or safety of apixaban.CONCLUSIONS: Multi-morbidity is prevalent among the population with AF; efficacy and safety of apixaban is preserved in this subgroup supporting extension of trial results to the most complex AF patients.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Brouwer, Marc A (författare)
  • Mulder, Hillary (författare)
  • Vinereanu, Dragos (författare)
  • Lopes, Renato D (författare)
  • Proietti, Marco (författare)
  • Al-Khatib, Sana M (författare)
  • Hijazi, ZiadUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi(Swepub:uu)ziahi940 (författare)
  • Halvorsen, Sigrun (författare)
  • Hylek, Elaine M (författare)
  • Verheugt, Freek W A (författare)
  • Alexander, John H (författare)
  • Wallentin, Lars,1943-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,UCR(Swepub:uu)larswall (författare)
  • Granger, Christopher B (författare)
  • Uppsala universitetUppsala kliniska forskningscentrum (UCR) (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:American Heart Journal: Elsevier BV208, s. 123-1310002-87031097-6744

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