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  • Becher, NinaDepartment of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany (författare)

Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h

  • Artikel/kapitelEngelska2024

Förlag, utgivningsår, omfång ...

  • Oxford University Press,2024
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:oru-109753
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-109753URI
  • https://doi.org/10.1093/eurheartj/ehad771DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

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

Anmärkningar

  • NOAH-AFNET6 was partially funded by BMBF (German Ministry of Education and Research, Berlin, Germany) through the DZHK (German Center for Cardiovascular Research, Berlin, Germany, grant number FKZ 81X2800182) and by Daiichi Sankyo Europe. Further support was provided by European Union CATCH ME (grant agreement no. 633196) to P.K. and U.S. and AFNET; AFFECTEU (grant agreement no. 847770) to P.K.; MAESTRIA (grant agreement 965286) to A.G., P.K., U.S. and AFNET; British Heart Foundation (AA/18/2/34218) to P.K.; German Research Foundation (Ki 509167694) to P.K.; DZHK (grant numbers 81Z0710116 and 81Z0710110) to P.K., Leducq Foundation to P.K., and the Dutch Heart Foundation (EmbRACE, grant number 01–002-2022-0118) to U.S. P.K. was partially supported by European Union AFFECT-EU (grant agreement no. 847770), MAESTRIA (grant agreement no. 965286), and British Heart Foundation (PG/17/30/32961; PG/20/22/35093; AA/18/2/34218); German Center for Cardiovascular Research supported by the German Ministry of Education and Research (DZHK, grant numbers DZHK FKZ 81X2800182, 81Z0710116, and 81Z0710110), German Research Foundation (Ki 509167694), and Leducq Foundation. R.B.S. has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme under the grant agreement no. 648131, the European Union’s Horizon 2020 research and innovation programme under the grant agreement no. 847770 (AFFECTEU); German Center for Cardiovascular Research (DZHK e.V.) (81Z1710103 and 81Z0710114); German Ministry of Research and Education (BMBF 01ZX1408A) and ERACoSysMed3 (031L0239); and Wolfgang Seefried project funding German Heart Foundation.
  • BACKGROUND AND AIMS: Patients with long atrial high-rate episodes (AHRE) ≥ 24 hours and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared to no anticoagulation in these patients.METHODS: This secondary prespecified analysis of NOAH-AFNET 6 examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared to placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and ECG-diagnosed atrial fibrillation.RESULTS: AHRE ≥24 hours were present at baseline in 259/2389 patients enrolled in NOAH-AFNET 6 (11%, 78 ± 7 years old, 28% women, CHA2DS2-VASc score 4). Clinical characteristics were not different from patients with shorter AHRE. During a median follow-up of 1.8 years, the primary outcome occurred in 9/132 patients with AHRE ≥24 hours (4.3%/patient-year, 2 strokes) treated with anticoagulation and in 14/127 patients treated with placebo (6.9%/patient-year, 2 strokes). AHRE duration did not interact with the efficacy (p-interaction = 0.65) or safety (p-interaction = 0.98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE ≥24 hours developed more ECG-diagnosed atrial fibrillation (17.0%/patient-year) than patients with shorter AHRE (8.2%/patient-year; p < 0.001).CONCLUSIONS: This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.

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

  • Toennis, TobiasDepartment of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany (författare)
  • Bertaglia, EmanueleDepartment of Cardiac, Vascular, Thoracic and Public Health Sciences, Azienda Ospedaliera, Padua, Italy (författare)
  • Blomström-Lundqvist, CarinaÖrebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Science, Uppsala University, Uppsala, Sweden; Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)cabt (författare)
  • Brandes, AxelDepartment of Cardiology, Esbjerg Hospital - University Hospital of Southern Denmark, Esbjerg, and Department of Regional Health Research, University of Southern Denmark, Odense, Denmark (författare)
  • Cabanelas, NunoCardiology Department, Fernando Fonseca Hospital, Amadora, Portugal (författare)
  • Calvert, MelanieCentre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom; NIHR Birmingham Biomedical Research Centre and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Edgbaston, Birmingham, UK (författare)
  • Camm, A. JohnCardiovascular and Cell Sciences Research Institute, St George's, University of London, and Imperial College, London, United Kingdom (författare)
  • Chlouverakis, GregoryBiostatistics Lab, School of Medicine, University of Crete, Crete, Greece (författare)
  • Dan, Gheorghe-AndreiMedicine University "Carol Davila", Colentina University Hospital, Bucharest, Romania (författare)
  • Dichtl, WolfgangDepartment of Internal Medicine III, Cardiology and Angiology, Innsbruck Medical University, Innsbruck, Austria (författare)
  • Diener, Hans ChristophDepartment of Neuroepidemiology, Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Duisburg-Essen, Essen, Germany (författare)
  • Fierenz, AlexanderInstitute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Germany (författare)
  • Goette, AndreasDepartment of Cardiology and Intensive Care Medicine, St Vincenz-Hospital Paderborn, Paderborn, Germany; Atrial Fibrillation NETwork (AFNET), Muenster, Germany (författare)
  • de Groot, Joris R.Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands (författare)
  • Hermans, Astrid N. L.Departments of Cardiology and Physiology, Maastricht University, Maastricht, The Netherlands (författare)
  • Lip, Gregory Y. H.Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; and Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (författare)
  • Lubinski, AndrzejMedical University of Gdańsk, Department of Cardiology and Internal Diseases, Gdańsk, Poland (författare)
  • Marijon, EloiCardiology Division, European Georges Pompidou Hospital, Paris, France (författare)
  • Merkely, BélaHeart and Vascular Centre, Semmelweis University, Budapest, Hungary (författare)
  • Mont, LluísHospital Clinic, Universtitat de Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigacion Biomedica en Red Cardiovascular (CIBERCV), Madrid, Spain (författare)
  • Ozga, Ann-KathrinInstitute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Germany (författare)
  • Rajappan, KimCardiac Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (författare)
  • Sarkozy, AndreaHRMC, University Hospital Brussels, VUB, Belgium (författare)
  • Scherr, DanielDepartment of Cardiology, University Hospital Graz, Austria (författare)
  • Schnabel, Renate BDepartment of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany (författare)
  • Schotten, UlrichDepartments of Cardiology and Physiology, Maastricht University, Maastricht, The Netherlands; Atrial Fibrillation NETwork (AFNET), Muenster, Germany (författare)
  • Sehner, SusanneInstitute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Germany (författare)
  • Simantirakis, EmmanuelDepartment of Cardiology, Heraklion University Hospital, Heraklion, Crete, Greece (författare)
  • Vardas, PanosDepartment of Cardiology, Heraklion University Hospital, Heraklion, Crete, Greece; Biomedical Research Foundation Academy of Athens (BRFAA), Greece and Hygeia Hospitals Group, Athens, Greece (författare)
  • Velchev, VasilCardiology Clinic, St. Anna University Hospital, Medical University Sofia, Sofia, Bulgaria (författare)
  • Wichterle, DanDepartment of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czechia (författare)
  • Zapf, AntoniaInstitute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Germany (författare)
  • Kirchhof, PaulusDepartment of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany; Atrial Fibrillation NETwork (AFNET), Muenster, Germany (författare)
  • NOAH-AFNET, - (bidragsgivare)
  • Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, GermanyDepartment of Cardiac, Vascular, Thoracic and Public Health Sciences, Azienda Ospedaliera, Padua, Italy (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:European Heart Journal: Oxford University Press45:10, s. 837-8490195-668X1522-9645

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