Document Detail

Effect of hypertension on anticoagulated patients with atrial fibrillation.
MedLine Citation:
PMID:  17289744     Owner:  NLM     Status:  MEDLINE    
AIM: To test the hypothesis that stroke and systemic embolic events (SEE) in the Stroke Prevention using an ORal Thrombin Inhibitor in atrial Fibrillation (SPORTIF) III and V trials were related to blood pressure, and that differences in event rates (stroke and SEE, bleeding) could also be related to the degree of hypertension. METHODS AND RESULTS: A cross-sectional, longitudinal analysis was conducted, using data from the SPORTIF III and V trials. Results showed an increasing rate of stroke and SEE with increasing quartiles of systolic blood pressure (SBP) in AF patients. For the top quartile of SBP compared with the lowest quartile, the hazard ratio (HR) for stroke and SEE was 1.83 (95% confidence intervals [CI]: 1.22-2.74), whereas mortality was lower in the top quartile (HR 0.64; 95% CI: 0.49-0.83). In the combined SPORTIF III and V cohort, the event rate for stroke/SEE increased markedly at mean SBP of > 140 mmHg. There was no relationship between bleeding and quartiles of BP. The proportion of subjects with mean systolic BP > or = 140 mmHg was 35.8% (1220/3407) in SPORTIF III and 20.6% (807/3922) in SPORTIF V (P < 0.0001). CONCLUSION: Hypertension contributes to increased stroke and SEE in AF. Event rates markedly increase at SBP levels of > or = 140 mmHg. The higher stroke rates observed in SPORTIF III compared with SPORTIF V may be related to the greater proportion of subjects with SBP > or = 140 mmHg during the trial.
Gregory Y H Lip; Lars Frison; Margaretha Grind;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2007-02-08
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-16     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  752-9     Citation Subset:  IM    
Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK.
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MeSH Terms
Anticoagulants / therapeutic use*
Atrial Fibrillation / complications,  drug therapy*
Azetidines / therapeutic use
Benzylamines / therapeutic use
Cross-Sectional Studies
Double-Blind Method
Hemorrhage / etiology,  prevention & control
Hypertension / complications*
Longitudinal Studies
Middle Aged
Risk Factors
Stroke / etiology,  prevention & control*
Thromboembolism / etiology,  prevention & control*
Warfarin / therapeutic use
Reg. No./Substance:
0/Anticoagulants; 0/Azetidines; 0/Benzylamines; 0/ximelagatran; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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