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Concomitant Oral An...
Concomitant Oral Anticoagulant and Nonsteroidal Anti-Inflammatory Drug Therapy in Patients With Atrial Fibrillation
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- Kent, Anthony P. (författare)
- Bridgeport Hosp, Yale New Haven Hlth, Dept Internal Med, Bridgeport, CT USA
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- Brueckmann, Martina (författare)
- Heidelberg Univ, Mannheim, Germany;Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany
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- Fraessdorf, Mandy (författare)
- Boehringer Ingelheim GmbH & Co KG, Ingelheim, Germany
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- Connolly, Stuart J. (författare)
- Populat Hlth Res Inst, Hamilton Hlth Sci, Hamilton, ON, Canada;McMaster Univ, Hamilton, ON, Canada
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- Yusuf, Salim (författare)
- Populat Hlth Res Inst, Hamilton Hlth Sci, Hamilton, ON, Canada;McMaster Univ, Hamilton, ON, Canada
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- Eikelboom, John W. (författare)
- Populat Hlth Res Inst, Hamilton Hlth Sci, Hamilton, ON, Canada;McMaster Univ, Hamilton, ON, Canada
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- Oldgren, Jonas, 1964- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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- Reilly, Paul A. (författare)
- Boehringer Ingelheim Pharmaceut, Cardiol, Clin Dev, Ridgefield, CT USA
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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- Ezekowitz, Michael D. (författare)
- Bryn Mawr Hosp, Philadelphia, PA USA;Thomas Jefferson Univ, Sidney Kimmel Med Coll, Philadelphia, PA 19107 USA;Lankenau Hosp, Philadelphia, PA USA
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(creator_code:org_t)
- ELSEVIER SCIENCE INC, 2018
- 2018
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 72:3, s. 255-267
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used medications that can potentially increase the risk of bleeding and thrombosis. OBJECTIVES This study quantified the effect of NSAIDs in the RE-LY (Randomized Evaluation of Long Term Anticoagulant Therapy) trial. METHODS This was a post hoc analysis of NSAIDs in the RE-LY study, which compared dabigatran etexilate (DE) 150 and 110 mg twice daily (b.i.d.) with warfarin in patients with atrial fibrillation. Treatment-independent, multivariate-adjusted Cox regression analysis assessed clinical outcomes by comparing NSAID use with no NSAID use. Interaction analysis was obtained from treatment-dependent Cox regression modeling. Time-varying covariate analysis for NSAID use was applied to the Cox model. RESULTS Among 18,113 patients in the RE-LY study, 2,279 patients used NSAIDs at least once during the trial. Major bleeding was significantly elevated with NSAID use (hazard ratio [HR]: 1.68; 95% confidence interval [CI]: 1.40 to 2.02; p < 0.0001). NSAID use did not significantly alter the risk of major bleeding for DE 150 or 110 mg b.i.d. relative to warfarin (pinteraction = 0.63 and 0.93, respectively). Gastrointestinal major bleeding was significantly elevated with NSAID use (HR: 1.81; 95% CI: 1.35 to 2.43; p < 0.0001). The rate of stroke or systemic embolism (stroke/SE) with NSAID use was significantly elevated (HR: 1.50; 95% CI: 1.12 to 2.01; p = 0.007). The use of NSAIDs did not significantly alter the relative efficacy on stroke/SE for DE 150 or 110 mg b.i.d. relative to warfarin (p(interaction) = 0.59 and 0.54, respectively). Myocardial infarction rates were similar with NSAID use compared with no NSAID use (HR: 1.22; 95% CI: 0.77 to 1.93; p = 0.40). Patients were more frequently hospitalized if they used an NSAID (HR: 1.64; 95% CI: 1.51 to 1.77; p < 0.0001). CONCLUSIONS The use of NSAIDs was associated with increased risk of major bleeding, stroke/SE, and hospitalization. The safety and efficacy of DE 150 and 110 mg b.i.d. relative to warfarin were not altered. (Randomized Evaluation of Long Term Anticoagulant Therapy [RE-LY]; NCT00262600)
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- anticoagulation
- atrial fibrillation
- bleeding
- NSAID
- stroke prevention
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Kent, Anthony P.
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Brueckmann, Mart ...
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Fraessdorf, Mand ...
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Connolly, Stuart ...
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Yusuf, Salim
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Eikelboom, John ...
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Oldgren, Jonas, ...
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Reilly, Paul A.
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Wallentin, Lars, ...
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Ezekowitz, Micha ...
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