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Cardiovascular consequences of discontinuing low-dose rivaroxaban in people with chronic coronary or peripheral artery disease
GR. Dagenais, L. Dyal, JJ. Bosch, DP. Leong, V. Aboyans, SD. Berkowitz, DL. Bhatt, SJ. Connolly, KAA. Fox, E. Muehlhofer, JL. Probstfield, P. Widimsky, BR. Winkelmann, S. Yusuf, JW. Eikelboom
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, randomizované kontrolované studie, práce podpořená grantem
NLK
ProQuest Central
od 1996-01-01 do Před 3 měsíci
Health & Medicine (ProQuest)
od 1996-01-01 do Před 3 měsíci
- MeSH
- Aspirin * aplikace a dávkování škodlivé účinky MeSH
- fibrinolytika aplikace a dávkování škodlivé účinky MeSH
- infarkt myokardu * etiologie mortalita prevence a kontrola MeSH
- ischemická cévní mozková příhoda * etiologie mortalita prevence a kontrola MeSH
- kombinovaná farmakoterapie metody MeSH
- koronární nemoc * diagnóza farmakoterapie MeSH
- lidé MeSH
- monitorování léčiv metody statistika a číselné údaje MeSH
- mortalita MeSH
- náhrada léků škodlivé účinky MeSH
- nenasazení léčby statistika a číselné údaje MeSH
- onemocnění periferních arterií * diagnóza farmakoterapie MeSH
- rivaroxaban * aplikace a dávkování škodlivé účinky MeSH
- senioři MeSH
- trvání terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
OBJECTIVE: In patients with chronic coronary or peripheral artery disease enrolled in the Cardiovascular Outcomes for People Using Anticoagulation Strategies trial, randomised antithrombotic treatments were stopped after a median follow-up of 23 months because of benefits of the combination of rivaroxaban 2.5 mg two times per day and aspirin 100 mg once daily compared with aspirin 100 mg once daily. We assessed the effect of switching to non-study aspirin at the time of early stopping. METHODS: Incident composite of myocardial infarction, stroke or cardiovascular death was estimated per 100 person-years (py) during randomised treatment (n=18 278) and after study treatment discontinuation to non-study aspirin (n=14 068). RESULTS: During randomised treatment, the combination compared with aspirin reduced the composite (2.2 vs 2.9/100 py, HR: 0.76, 95% CI 0.66 to 0.86), stroke (0.5 vs 0.8/100 py, HR: 0.58, 95% CI 0.44 to 0.76) and cardiovascular death (0.9 vs 1.2/100 py, HR: 0.78, 95% CI 0.64 to 0.96). During 1.02 years after early stopping, participants originally randomised to the combination compared with those randomised to aspirin had similar rates of the composite (2.1 vs 2.0/100 py, HR: 1.08, 95% CI 0.84 to 1.39) and cardiovascular death (1.0 vs 0.8/100 py, HR: 1.26, 95% CI 0.85 to 1.86) but higher stroke rate (0.7 vs 0.4/100 py, HR: 1.74, 95% CI 1.05 to 2.87) including a significant increase in ischaemic stroke during the first 6 months after switching to non-study aspirin. CONCLUSION: Discontinuing study rivaroxaban and aspirin to non-study aspirin was associated with the loss of cardiovascular benefits and a stroke excess. TRIAL REGISTRATION NUMBER: NCT01776424.
Bayer HealthCare Pharmaceuticals Whippany New Jersey USA
Department of Cardiology Dupuytren University Hospital Limoges France
Department of Cardiology INSERM U1094 Tropical Neuroepidemiology Limoges France
Department of Cardiology Laval University Heart and Lung Institute Quebec Québec Canada
Department of Medicine University of Edinburgh Edinburgh UK
Department of Medicine University of Washington Medical Centre Seattle Washington USA
Citace poskytuje Crossref.org
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