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Sökning: onr:"swepub:oai:DiVA.org:uu-188429" > Efficacy of apixaba...

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FältnamnIndikatorerMetadata
00003629naa a2200457 4500
001oai:DiVA.org:uu-188429
003SwePub
008121217s2012 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-1884292 URI
0247 a https://doi.org/10.1093/eurheartj/ehs2742 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Hohnloser, Stefan H.4 aut
2451 0a Efficacy of apixaban when compared with warfarin in relation to renal function in patients with atrial fibrillation :b insights from the ARISTOTLE trial
264 c 2012-08-29
264 1b Oxford University Press (OUP),c 2012
338 a print2 rdacarrier
520 a AimsAtrial fibrillation (AF) is common among patients with impaired renal function. Apixaban, a novel oral anticoagulant with partial renal excretion, was compared with warfarin and reduced the rate stroke, death and bleeding in the ARISTOTLE trial. We evaluated these outcomes in relation to renal function.Methods and resultsBaseline glomerular filtration rate (GFR) was estimated using the Cockcroft–Gault and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations as well as cystatin C measurements. According to baseline Cockcroft–Gault, there were 7518 patients (42%) with an estimated GFR (eGFR) of >80 mL/min, 7587 (42%) between >50 and 80 mL/min, and 3017 (15%) with an eGFR of ≤50 mL/min. The rate of cardiovascular events and bleeding was higher at impaired renal function (≤80 mL/min). Apixaban was more effective than warfarin in preventing stroke or systemic embolism and reducing mortality irrespective of renal function. These results were consistent, regardless of methods for GFR estimation. Apixaban was associated with less major bleeding events across all ranges of eGFRs. The relative risk reduction in major bleeding was greater in patients with an eGFR of ≤50 mL/min using Cockcroft–Gault {hazard ratio (HR) 0.50 [95% confidence interval (CI) 0.38–0.66], interaction P = 0.005} or CKD-EPI equations [HR 0.48 (95% CI 0.37–0.64), interaction P = 0.003].ConclusionIn patients with AF, renal impairment was associated with increased risk of cardiovascular events and bleeding. When compared with warfarin, apixaban treatment reduced the rate of stroke, death, and major bleeding, regardless of renal function. Patients with impaired renal function seemed to have the greatest reduction in major bleeding with apixaban.
653 a Atrial fibrillation
653 a Anticoagulation
653 a Stroke prevention
653 a Bleeding
653 a Apixaban
7001 a Hijazi, Ziadu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)ziahi940
7001 a Thomas, Laine4 aut
7001 a Alexander, John H.4 aut
7001 a Amerena, John4 aut
7001 a Hanna, Michael4 aut
7001 a Keltai, Matyas4 aut
7001 a Lanas, Fernando4 aut
7001 a Lopes, Renato D.4 aut
7001 a Lopez-Sendon, Jose4 aut
7001 a Granger, Christopher B.4 aut
7001 a Wallentin, Larsu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)larswall
7102 a Uppsala universitetb Uppsala kliniska forskningscentrum (UCR)4 org
7730 t European Heart Journald : Oxford University Press (OUP)g 33:22, s. 2821-2830q 33:22<2821-2830x 0195-668Xx 1522-9645
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-188429
8564 8u https://doi.org/10.1093/eurheartj/ehs274

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