Anticoagulation in patients with device-detected atrial fibrillation with and without a prior stroke or transient ischemic attack: dThe NOAH-AFNET 6 Trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00085045" target="_blank" >RIV/00023001:_____/24:00085045 - isvavai.cz</a>

Result on the web

<a href="https://www.ahajournals.org/doi/pdf/10.1161/JAHA.124.036429" target="_blank" >https://www.ahajournals.org/doi/pdf/10.1161/JAHA.124.036429</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1161/JAHA.124.036429" target="_blank" >10.1161/JAHA.124.036429</a>

Result language

angličtina

Original language name

Anticoagulation in patients with device-detected atrial fibrillation with and without a prior stroke or transient ischemic attack: dThe NOAH-AFNET 6 Trial

Original language description

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.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of the American Heart Association [online]

ISSN

2047-9980

e-ISSN

2047-9980

Volume of the periodical

13

Issue of the periodical within the volume

17

Country of publishing house

US - UNITED STATES

Number of pages

13

Pages from-to

"art. no. e036429"

UT code for WoS article

001304211600052

EID of the result in the Scopus database

2-s2.0-85203203071