Comparative effects of antiplatelet, anticoagulant, or combined therapy in patients with valvular and nonvalvular atrial fibrillation

Pérez-Gómez, Francisco; Alegría, Eduardo; Berjón, Jesús

doi:10.1016/j.accreview.2004.12.140

Cited by 19 publications

(26 citation statements)

References 59 publications

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“…The study design, inclusion and exclusion criteria, statistical analysis and general results, have been given in a previous publication. 8 More detailed results on mitral stenosis patients have also been reported. 9 We included in this analysis all valvular and non-valvular patients randomized to anticoagulant-alone or combined therapy, who were previously divided into two groups according to diagnostic criteria and the prevalence of baseline risk factors.…”

Section: Study Population and Randomized Treatmentsmentioning

confidence: 98%

“…These patients were also randomized to anticoagulant therapy alone for an INR range of 2.0-3.0 or to the combined therapy for an INR range of 1.25-2.0, although the resultant mean value was 1.97. 8 Patients randomized to antiplatelet therapy alone were not included in this analysis. The planned length of follow-up was 4 years and the patients were controlled every 6 months.…”

Section: Study Population and Randomized Treatmentsmentioning

confidence: 99%

“…7 Our recent articles showed that combined antiplatelet plus moderate anticoagulant therapy (combined therapy), compared with anticoagulant-alone therapy, significantly reduced the events-rate in patients of the National Study for Prevention of Embolism in AF (NASPEAF). 8,9 This benefit was obtained without increasing the risk of severe bleeding. It was the intention of this analysis to evaluate and compare the effects and bleeding risk of these two antithrombotic therapies in our randomized cohort of patients stratified into two age groups: older and younger than 75 years.…”

Section: Introductionmentioning

confidence: 99%

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Antithrombotic therapy in elderly patients with atrial fibrillation: effects and bleeding complications: a stratified analysis of the NASPEAF randomized trial

Pérez-Gómez¹,

Iriarte²,

Zumalde³

et al. 2007

European Heart Journal

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Section: Study Population and Randomized Treatmentsmentioning

confidence: 98%

Section: Study Population and Randomized Treatmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antithrombotic therapy in elderly patients with atrial fibrillation: effects and bleeding complications: a stratified analysis of the NASPEAF randomized trial

Pérez-Gómez¹,

Iriarte²,

Zumalde³

et al. 2007

European Heart Journal

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“…All patients were being treated with 100 mg/day underwent PCI developed AF [6][7][8] , and the reported incidence of major bleeding events in those who received the combination of DAPT plus anticoagulants was 2.2% within the first month and 4%-12% within the first year of treatment 9) . Previous studies showed that the DAPT score allowed the successful stratification of bleeding risks 10) , and the European Society of Cardiology guidelines recommended the use of this score to stratify stroke risk, bleeding risk, and clinical setting regarding the use of antithrombotic therapy in patients with CAD and AF 11) .…”

Section: Antiplatelet Therapymentioning

confidence: 99%

Total Thrombus-Formation Analysis System can Predict 1-Year Bleeding Events in Patients with Coronary Artery Disease

Mitsuse

Kaikita

Ishii

et al. 2020

JAT

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The assessment of bleeding risk in patients with coronary artery disease (CAD) is clinically important. We recently developed the Total Thrombus-Formation Analysis System (T-TAS) for the quantitative analysis of thrombus formation using microchips with thrombogenic surfaces. Here, we assessed the utility of T-TAS parameters in predicting 1-year bleeding events in patients with CAD. Methods: The study subjects were 561 consecutive patients who underwent coronary angiography (CAG) between August 2013 and September 2016 for suspected CAD. Blood samples collected at the time of CAG were used for T-TAS to compute the area under the curve (AUC) (AR10-AUC30) in the AR chip. Patients were divided into three groups according to AR10-AUC30 (low: ≤ 1603, intermediate, and high: 1765, n 187 each). Oneyear bleeding events were defined by the Platelet Inhibition and Patient Outcomes criteria. Results: Bleeding occurred in 21 (3.7%) patients and was classified as major (8 [1.4%]) and minor (13 [2.3%]). The AR10-AUC30 levels were significantly lower in the bleeding group than the non-bleeding group (median [interquartile range] 1590 [1442-1734] vs. 1687 [1546-1797], p 0.04). Univariate Cox regression analysis demonstrated that low AR10-AUC30 , high prothrombin time-international normalized ratio levels, and diabetes correlated with bleeding events. Multivariate Cox regression analysis identified low AR10-AUC30 levels as a significant determinant of bleeding events. Kaplan-Meier survival curves showed a higher rate of bleeding events in the low than the high AR10-AUC30 group (p 0.007). Conclusions: The results highlight the potential usefulness of the AR10-AUC30 levels in the prediction of 1-year bleeding events in patients with CAD treated with various antithrombotic therapies. (AF) and venous thromboembolism. However, there is no adequate monitoring system that can evaluate antithrombotic drugs. Bleeding events are one of the major concerns in patients treated with these drugs. Bleeding events after PCI are associated with early and late mortality 1-4). The reported incidence of major bleeding events in patients with stable coronary artery disease (CAD) is 0.6%/year, and major bleeding events are significantly associated with mortality 5). Furthermore, approximately 5%-8% of patients who Copyright©2019 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

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“…1 In addition to superiority over placebo, there is clear evidence of the efficacy of adjusted-dose oral anticoagulants to reduce stroke, disabling stroke, and other major vascular events for those with nonvalvular AF when compared with antiplatelet therapy. 2,27,[30][31][32][33][34][35][36][37][38][39][40][41] Finally, we now also have data on the superiority of warfarin in the elderly in a primary care setting. In the Birmingham Atrial Fibrillation in the Aged (BAFTA) trial, patients 75 (n ¼ 973) were either treated with 75 mg/day aspirin or warfarin targeting an INR of 2.5 (range, 2.0 to 3.0).…”

Section: Improving Antithrombotic Management/levi Et Almentioning

confidence: 99%

Improving Antithrombotic Management in Patients With Atrial Fibrillation: Current Status and Perspectives

Levi

Hobbs

Jacobson

et al. 2009

Semin Thromb Hemost

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Despite overwhelming evidence of the benefits of risk-adjusted oral anticoagulation on stroke reduction in patients with atrial fibrillation (AF), there is still considerable undertreatment. A multidisciplinary expert group was formed to discuss issues surrounding anticoagulant treatment of patients with AF to try and achieve consensus on various aspects of the implementation of guidelines on oral anticoagulation therapy in AF. Panel members were cardiologists, hematologists, and laboratory and primary care physicians with specific expertise from Europe and the United States. One of the most important conclusions of the meeting was to enhance guideline adherence by better communication of the data showing that the benefits of stroke reduction outweigh the risk of bleeding associated with treatment with vitamin K antagonists. Management of oral anticoagulation therapy by dedicated centers, such as anticoagulation clinics, or by patient self-management may improve the quality of anticoagulation and facilitate the management of these patients and thereby further facilitate optimal antithrombotic management in patients with AF.

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Comparative effects of antiplatelet, anticoagulant, or combined therapy in patients with valvular and nonvalvular atrial fibrillation

Cited by 19 publications

References 59 publications

Antithrombotic therapy in elderly patients with atrial fibrillation: effects and bleeding complications: a stratified analysis of the NASPEAF randomized trial

Antithrombotic therapy in elderly patients with atrial fibrillation: effects and bleeding complications: a stratified analysis of the NASPEAF randomized trial

Total Thrombus-Formation Analysis System can Predict 1-Year Bleeding Events in Patients with Coronary Artery Disease

Improving Antithrombotic Management in Patients With Atrial Fibrillation: Current Status and Perspectives

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