Apixaban vs Aspirin According to CHA 2 DS 2-VASc Score in Subclinical Atrial Fibrillation From ARTESiA

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00085755" target="_blank" >RIV/00023001:_____/24:00085755 - isvavai.cz</a>

Result on the web

<a href="https://www.sciencedirect.com/science/article/pii/S0735109724071602?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/pii/S0735109724071602?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jacc.2024.05.002" target="_blank" >10.1016/j.jacc.2024.05.002</a>

Result language

angličtina

Original language name

Apixaban vs Aspirin According to CHA 2 DS 2-VASc Score in Subclinical Atrial Fibrillation From ARTESiA

Original language description

Background ARTESiA (Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation) demonstrated that apixaban, compared with aspirin, significantly reduced stroke and systemic embolism (SE) but increased major bleeding in patients with subclinical atrial fibrillation. Objectives To help inform decision making, the authors evaluated the efficacy and safety of apixaban according to baseline CHA(2)DS(2)-VASc score. Methods We performed a subgroup analysis according to baseline CHA(2)DS(2)-VASc score and assessed both the relative and absolute differences in stroke/SE and major bleeding. Results Baseline CHA(2)DS(2)-VASc scores were &lt;4 in 1,578 (39.4%) patients, 4 in 1,349 (33.6%), and &gt;4 in 1,085 (27.0%). For patients with CHA(2)DS(2)-VASc &gt;4, the rate of stroke was 0.98%/year with apixaban and 2.25%/year with aspirin; compared with aspirin, apixaban prevented 1.28 (95% CI: 0.43-2.12) strokes/SE per 100 patient-years and caused 0.68 (95% CI: -0.23 to 1.57) major bleeds. For CHA(2)DS(2)-VASc &lt;4, the stroke/SE rate was 0.85%/year with apixaban and 0.97%/year with aspirin. Apixaban prevented 0.12 (95% CI: -0.38 to 0.62) strokes/SE per 100 patient-years and caused 0.33 (95% CI: -0.27 to 0.92) major bleeds. For patients with CHA(2)DS(2)-VASc =4, apixaban prevented 0.32 (95% CI: -0.16 to 0.79) strokes/SE per 100 patient-years and caused 0.28 (95% CI: -0.30 to 0.86) major bleeds. Conclusions One in 4 patients in ARTESiA with subclinical atrial fibrillation had a CHA(2)DS(2)-VASc score &gt;4 and a stroke/SE risk of 2.2% per year. For these patients, the benefits of treatment with apixaban in preventing stroke/SE are greater than the risks. The opposite is true for patients with CHA(2)DS(2)-VASc score &lt;4. A substantial intermediate group (CHA(2)DS(2)-VASc =4) exists in which patient preferences will inform treatment decisions. (Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation; NCT01938248)

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 College of Cardiology

ISSN

0735-1097

e-ISSN

1558-3597

Volume of the periodical

84

Issue of the periodical within the volume

4

Country of publishing house

US - UNITED STATES

Number of pages

11

Pages from-to

354-364

UT code for WoS article

001275657400001

EID of the result in the Scopus database

2-s2.0-85197642552