Repositorio UFRO · Omeka S

Efficacy and Safety of Apixaban Compared With Warfarin at Different Levels of Predicted International Normalized Ratio Control for Stroke Prevention in Atrial Fibrillation

Primer Autor	Wallentin, Lars
Co-autores	Lopes, Renato D. Hanna, Michael Thomas, Laine Hellkamp, Anne Nepal, Sunil Hylek, Elaine M. Al-Khatib, Sana M. Alexander, John H. Alings, Marco Amerena, John Ansell, Jack Aylward, Philip Bartunek, Jozef Commerford, Patrick De Caterina, Raffaele Erol, Cetin Harjola, Veli-Pekka Held, Claes Horowitz, John D. Huber, Kurt Husted, Steen Keltai, Matyas Lanas, Fernando Liu Lisheng McMurray, John J. V. Oh, Byung-Hee Rosenqvist, Marten Ruzyllo, Witold Steg, Philippe Gabriel Vinereanu, Dragos Xavier, Denis Granger, Christopher B.
Título	Efficacy and Safety of Apixaban Compared With Warfarin at Different Levels of Predicted International Normalized Ratio Control for Stroke Prevention in Atrial Fibrillation
Editorial	LIPPINCOTT WILLIAMS & WILKINS
Revista	CIRCULATION
Lenguaje	en
Resumen	Background-In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced stroke and systemic embolism, major bleeding, and mortality. We evaluated treatment effects in relation to 2 predictions of time in therapeutic range (TTR). Methods and Results-The trial randomized 18 201 patients with atrial fibrillation to apixaban 5 mg twice daily or warfarin for at least 12 months. For each patient, a center average TTR was estimated with the use of a linear mixed model on the basis of the real TTRs in its warfarin-treated patients, with a fixed effect for country and random effect for center. For each patient, an individual TTR was also predicted with the use of a linear mixed effects model including patient characteristics as well. Median center average TTR was 66% (interquartile limits, 61% and 71%). Rates of stroke or systemic embolism, major bleeding, and mortality were consistently lower with apixaban than with warfarin across center average TTR and individual TTR quartiles. In the lowest and highest center average TTR quartiles, hazard ratios for stroke or systemic embolism were 0.73 (95% confidence interval [CI], 0.53-1.00) and 0.88 (95% CI, 0.57-1.35) (P-interaction = 0.078), for mortality were 0.91 (95% CI, 0.74-1.13) and 0.91 (95% CI, 0.71-1.16) (P-interaction = 0.34), and for major bleeding were 0.50 (95% CI, 0.36-0.70) and 0.75 (95% CI, 0.58-0.97) (P-interaction = 0.095), respectively. Similar results were seen for quartiles of individual TTR. Conclusions-The benefits of apixaban compared with warfarin for stroke or systemic embolism, bleeding, and mortality appear similar across the range of centers' and patients' predicted quality of international normalized ratio control.
Tipo de Recurso	Artículo original
Description	This trial was funded by Bristol-Myers Squibb, Co, Princeton, NJ, and Pfizer Inc, New York, NY. Este ensayo fue financiado por Bristol-Myers Squibb, Co., Princeton, NJ, y Pfizer Inc., Nueva York, NY.
doi	10.1161/CIRCULATIONAHA.112.142158
Formato Recurso	pdf
Palabras Claves	anticoagulation apixaban atrial fibrillation bleeding stroke warfarin ORAL ANTICOAGULANT-THERAPY INTENSITY OUTCOMES GUIDELINES DABIGATRAN MANAGEMENT REDUCTION QUALITY TIME anticoagulación apixabán fibrilación auricular hemorragia accidente cerebrovascular warfarina TERAPIA ANTICOAGULANTE ORAL INTENSIDAD RESULTADOS DIRECTRICES DABIGATRÁN MANEJO REDUCCIÓN CALIDAD TIEMPO
Ubicación del archivo	http://dx.doi.org/10.1161/CIRCULATIONAHA.112.142158
Materias	anticoagulation apixaban atrial fibrillation bleeding stroke warfarin ORAL ANTICOAGULANT-THERAPY INTENSITY OUTCOMES GUIDELINES DABIGATRAN MANAGEMENT REDUCTION QUALITY TIME anticoagulación apixabán fibrilación auricular hemorragia accidente cerebrovascular warfarina TERAPIA ANTICOAGULANTE ORAL INTENSIDAD RESULTADOS DIRECTRICES DABIGATRÁN MANEJO REDUCCIÓN CALIDAD TIEMPO
Disciplinas de la OCDE	Sistema Cardiovascular y Cardiaco Medicina General e Interna
Título de la cita (Recomendado-único)	Efficacy and Safety of Apixaban Compared With Warfarin at Different Levels of Predicted International Normalized Ratio Control for Stroke Prevention in Atrial Fibrillation
Revista/Libro	CIRCULATION
Tipo de ruta	hibrida verde
Access Rights	acceso abierto
Derechos de acceso	acceso abierto
Identificador alternativo	PMID 23640971
Idioma	en
Identificador del recurso (Mandatado-único)	Artículo original
Versión del recurso (Recomendado-único)	versión publicada
Entidad financiadora	Bristol-Myers Squibb, Co, Princeton, NJ#Pfizer Inc, New York, NY
Referencia del Financiador (Mandatado si es aplicable-repetible)	Bristol-Myers Squibb, Co, Princeton, NJ Pfizer Inc, New York, NY
Editorial	LIPPINCOTT WILLIAMS & WILKINS
ISSN	0009-7322
Página de inicio (Recomendado-único)	2166
Página final (Recomendado-único)	#ERROR!
Categoría WOS	Sistemas cardíaco y cardiovascular enfermedad vascular periférica Cardiac & Cardiovascular Systems Peripheral Vascular Disease
Formato	pdf
Id de Web of Science	WOS:000330346900008