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Apixaban versus war...
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Garcia, David A.
(author)
Apixaban versus warfarin in patients with atrial fibrillation according to prior warfarin use : Results from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial
- Article/chapterEnglish2013
Publisher, publication year, extent ...
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Elsevier BV,2013
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-209168
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-209168URI
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https://doi.org/10.1016/j.ahj.2013.05.016DOI
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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Background Patients with atrial fibrillation who are vitamin K antagonist (VKA)-naive may have a higher risk of thrombosis and/or bleeding than VKA-experienced patients. Methods and results Using data from ARISTOTLE, we assessed baseline characteristics and the treatment effect of apixaban versus warfarin in the VKA-naive and VKA-experienced cohorts. We compared rates of study drug discontinuation and time-in-therapeutic range. Overall, 7,800 (43%) were VKA naive, and 10,401 were VKA experienced. At baseline, both groups were similar with respect to age and congestive heart failure, hypertension, age, diabetes, stroke score (CHADS(2)). Fewer VKA-naive patients had a history of prior stroke (18% vs 21%) or prior bleeding (10% vs 22%) and were more often female (39% vs 33%). The effect of apixaban on the primary efficacy and safety outcomes was similar in VKA-naive (stroke/systemic embolism: hazard ratio [ HR] 0.86, 95% CI 0.67-1.11 and major bleeding: HR 0.73, 95% CI 0.59-0.91) and VKA-experienced populations (stroke/systemic embolism: HR 0.73, 95% CI 0.57-0.95, P value for interaction = 0.39 and major bleeding: HR 0.66, 95% CI 0.55-0.80, P value for interaction = 0.50). Permanent study drug discontinuation was numerically less likely in patients receiving apixaban whether they were VKA naive (HR for discontinuation: 0.87, 95% CI 0.79-0.95) or VKA experienced (HR for discontinuation: 0.93, 95% CI 0.85-1.02). Among patients receiving warfarin, the mean/median times in therapeutic range were lower in the VKA-naive group (VKA-naive: 57.5/61.4, VKA-experienced: 66.0/69.1, P < .001). Conclusion The treatment effects of apixaban (vs warfarin) were not modified by VKA naivety. The rates of stroke/systemic embolism and major bleeding were numerically lower among the patients assigned to apixaban, irrespective of prior VKA use.
Added entries (persons, corporate bodies, meetings, titles ...)
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Wallentin, LarsUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)larswall
(author)
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Lopes, Renato D.
(author)
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Thomas, Laine
(author)
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Alexander, John H.
(author)
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Hylek, Elaine M.
(author)
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Ansell, Jack
(author)
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Hanna, Michael
(author)
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Lanas, Fernando
(author)
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Flaker, Greg
(author)
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Commerford, Patrick
(author)
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Xavier, Denis
(author)
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Vinereanu, Dragos
(author)
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Yang, Hongqiu
(author)
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Granger, Christopher B.
(author)
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Uppsala universitetUppsala kliniska forskningscentrum (UCR)
(creator_code:org_t)
Related titles
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In:American Heart Journal: Elsevier BV166:3, s. 549-5580002-87031097-6744
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Garcia, David A.
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Wallentin, Lars
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Lopes, Renato D.
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Thomas, Laine
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Alexander, John ...
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Hylek, Elaine M.
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Ansell, Jack
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Hanna, Michael
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Lanas, Fernando
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Flaker, Greg
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Commerford, Patr ...
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Xavier, Denis
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Vinereanu, Drago ...
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Yang, Hongqiu
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Granger, Christo ...
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American Heart J ...
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Uppsala University