Document Detail


Efficacy and Safety of Apixaban in Patients Following Cardioversion for Atrial Fibrillation: Insights from the ARISTOTLE trial.
MedLine Citation:
PMID:  24211508     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To determine the risk of major clinical and thromboembolic events after cardioversion for atrial fibrillation in subjects treated with apixaban, an oral factor Xa inhibitor compared with warfarin.
BACKGROUND: In patients with atrial fibrillation (AF), thromboembolic events may occur after cardioversion. This risk is lowered with vitamin K antagonists and dabigatran.
METHODS: Using data from ARISTOTLE, we conducted a post-hoc analysis of patients undergoing cardioversion.
RESULTS: A total of 743 cardioversions in 540 patients were performed: 265 first cardioversions in patients assigned to apixaban and 275 in those receiving warfarin. The mean time to the first cardioversion for patients assigned to warfarin and apixaban was 243 + 231 and 251 + 248 days respectively; 75% of the cardioversions occurred by 1 year. Baseline characteristics were similar between groups. In patients undergoing cardioversion, no stroke or systemic emboli occurred in the 30 day follow-up period. MI occurred in 1 patient (0.2%) receiving warfarin and 1 receiving apixaban (0.3%). Major bleeding occurred in 1 patient (0.2%) receiving warfarin and 1 receiving apixaban (0.3%). Death occurred in 2 patients (0.5%) receiving warfarin and 2 patients receiving apixaban (0.6%).
CONCLUSIONS: Major cardiovascular events after cardioversion of AF are rare and comparable between warfarin and apixaban.
Authors:
Greg Flaker; Renato D Lopes; Sana M Al-Khatib; Antonio G Hermosillo; Stefan H Hohnloser; Brian Tinga; Jun Zhu; Puneet Mohan; David Garcia; Jozef Bartunek; Dragos Vinereanu; Steen Husted; Veli Pekka Harjola; Marten Rosenqvist; John H Alexander; Christopher B Granger;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-26
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  -     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-11-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
University of Missouri, Columbia, MO. Electronic address: flakerg@missouri.edu.
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