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Anticoagulation in Patients With Device-Detected Atrial Fibrillation With and Without a Prior Stroke or Transient Ischemic Attack: The NOAH-AFNET 6 Trial
HC. Diener, N. Becher, S. Sehner, T. Toennis, E. Bertaglia, C. Blomstrom-Lundqvist, A. Brandes, V. Beuger, M. Calvert, AJ. Camm, G. Chlouverakis, GA. Dan, W. Dichtl, A. Fierenz, A. Goette, JR. de Groot, A. Hermans, GYH. Lip, A. Lubinski, E....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, randomizované kontrolované studie, multicentrická studie
NLK
Directory of Open Access Journals
od 2012
Free Medical Journals
od 2012
PubMed Central
od 2012
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od 2012
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od 2012-01-01
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od 2012
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od 2012
PubMed
39190564
DOI
10.1161/jaha.124.036429
Knihovny.cz E-zdroje
- MeSH
- antikoagulancia * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- aplikace orální MeSH
- časové faktory MeSH
- cévní mozková příhoda * prevence a kontrola etiologie MeSH
- dvojitá slepá metoda MeSH
- fibrilace síní * farmakoterapie komplikace diagnóza MeSH
- kardiostimulátor MeSH
- krvácení chemicky indukované MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- tranzitorní ischemická ataka * prevence a kontrola etiologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: Short and rare episodes of atrial fibrillation (AF) are commonly detected using implanted devices (device-detected AF) in patients with prior stroke or transient ischemic attack (TIA). The effectiveness and safety of oral anticoagulation in patients with prior stroke or TIA and device-detected AF but with no ECG-documented AF is unclear. METHODS AND RESULTS: This prespecified analysis of the NOAH-AFNET 6 (Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes) trial with post hoc elements assessed the effect of oral anticoagulation in patients with device-detected AF with and without a prior stroke or TIA in the randomized, double-blind, double-dummy NOAH-AFNET 6 trial. Outcomes were stroke, systemic embolism, and cardiovascular death (primary outcome) and major bleeding and death (safety outcome). A prior stroke or TIA was found in 253 patients with device-detected AF randomized in the NOAH-AFNET 6 (mean age, 78 years; 36.4% women). There was no treatment interaction with prior stroke or TIA for any of the primary and secondary time-to-event outcomes. In patients with a prior stroke or TIA, 14 out of 122 patients experienced a primary outcome event with anticoagulation (5.7% per patient-year). Without anticoagulation, there were 16 out of 131 patients with an event (6.3% per patient-year). The rate of stroke was lower than expected (anticoagulation: 4 out of 122 [1.6% per patient-year]; no anticoagulation: 6 out of 131 [2.3% per patient-year]). Numerically, there were more major bleeding events with anticoagulation in patients with prior stroke or TIA (8 out of 122 patients) than without anticoagulation (2 out of 131 patients). CONCLUSIONS: Anticoagulation appears to have ambiguous effects in patients with device-detected AF and a prior stroke or TIA in this hypothesis-generating analysis of the NOAH-AFNET 6 in the absence of ECG-documented AF, partially due to a low rate of stroke without anticoagulation.
Atrial Fibrillation Network Muenster Germany
Biomedical Research Foundation Academy of Athens Greece and Hygeia Hospitals Group Athens Greece
Biostatistics Laboratory School of Medicine University of Crete Crete Greece
Cardiology Division European Georges Pompidou Hospital Paris France
Cardiology Unit Camposampiero Hospital AULSS Euganea Padua Italy
Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares Madrid Spain
Department of Cardiology and Intensive Care Medicine St Vincenz Hospital Paderborn Paderborn Germany
Department of Cardiology and Internal Diseases Medical University of Gdańsk Gdańsk Poland
Department of Cardiology and Physiology Maastricht University Maastricht the Netherlands
Department of Cardiology Esbjerg Hospital University Hospital of Southern Denmark Esbjerg Denmark
Department of Cardiology Heraklion University Hospital Heraklion Greece
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czechia
Department of Cardiology Medical University of Graz Graz Austria
Department of Medical Science Uppsala University Uppsala Sweden
German Center for Cardiovascular Research Partner Site Hamburg Kiel Luebeck Hamburg Germany
Heart and Vascular Center Semmelweis University Budapest Hungary
Hospital Clínic Universitat de Barcelona Barcelona Catalonia Spain
HRMC University Hospital Brussels VUB Brussels Belgium Belgium
Institut d'Investigacions Biomèdiques August Pi i Sunyer Barcelona Catalonia Spain
Medicine University Carol Davila Colentina University Hospital Bucharest Romania
Citace poskytuje Crossref.org
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