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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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)

Název v anglickém jazyce

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

Popis výsledku anglicky

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)

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2024

Kód důvěrnosti údajů

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

Název periodika

Journal of the American College of Cardiology

ISSN

0735-1097

e-ISSN

1558-3597

Svazek periodika

84

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

354-364

Kód UT WoS článku

001275657400001

EID výsledku v databázi Scopus

2-s2.0-85197642552