Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Diener, HC; Becher, N; Sehner, S; Toennis, T; Bertaglia, E; Blomstrom-Lundqvist, C; Brandes, A; Beuger, V; Calvert, M; Camm, AJ; Chlouverakis, G; Dan, GA; Dichtl, W; Fierenz, A; Goette, A; de, Groot, JR; Hermans, A; Lip, GYH; Lubinski, A; Marijon, E; Merkely, B; Mont, L; Nikorowitsch, J; Ozga, AK; Rajappan, K; Sarkozy, A; Scherr, D; Schnabel, RB; Schotten, U; Simantirakis, E; Vardas, P; Wichterle, D; Zapf, A; Kirchhof, P, , NOAH‐AFNET, 6, investigators.
Anticoagulation in Patients With Device-Detected Atrial Fibrillation With and Without a Prior Stroke or Transient Ischemic Attack: The NOAH-AFNET 6 Trial.
J Am Heart Assoc. 2024; 13(17):e036429
Doi: 10.1161/JAHA.124.036429
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- Co-Autor*innen der Med Uni Graz
- Scherr Daniel
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- Abstract:
- BACKGROUND: Short and rare episodes of atrial fibrillation (AF) are commonly detected using implanted devices (device-detected AF) in patients with prior stroke or transient ischemic attack (TIA). The effectiveness and safety of oral anticoagulation in patients with prior stroke or TIA and device-detected AF but with no ECG-documented AF is unclear. METHODS AND RESULTS: This prespecified analysis of the NOAH-AFNET 6 (Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes) trial with post hoc elements assessed the effect of oral anticoagulation in patients with device-detected AF with and without a prior stroke or TIA in the randomized, double-blind, double-dummy NOAH-AFNET 6 trial. Outcomes were stroke, systemic embolism, and cardiovascular death (primary outcome) and major bleeding and death (safety outcome). A prior stroke or TIA was found in 253 patients with device-detected AF randomized in the NOAH-AFNET 6 (mean age, 78 years; 36.4% women). There was no treatment interaction with prior stroke or TIA for any of the primary and secondary time-to-event outcomes. In patients with a prior stroke or TIA, 14 out of 122 patients experienced a primary outcome event with anticoagulation (5.7% per patient-year). Without anticoagulation, there were 16 out of 131 patients with an event (6.3% per patient-year). The rate of stroke was lower than expected (anticoagulation: 4 out of 122 [1.6% per patient-year]; no anticoagulation: 6 out of 131 [2.3% per patient-year]). Numerically, there were more major bleeding events with anticoagulation in patients with prior stroke or TIA (8 out of 122 patients) than without anticoagulation (2 out of 131 patients). CONCLUSIONS: Anticoagulation appears to have ambiguous effects in patients with device-detected AF and a prior stroke or TIA in this hypothesis-generating analysis of the NOAH-AFNET 6 in the absence of ECG-documented AF, partially due to a low rate of stroke without anticoagulation.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Atrial Fibrillation - drug therapy, complications, diagnosis
- Ischemic Attack, Transient - prevention & control, etiology
- Female - administration & dosage
- Aged - administration & dosage
- Male - administration & dosage
- Anticoagulants - administration & dosage, adverse effects, therapeutic use
- Stroke - prevention & control, etiology
- Double-Blind Method - administration & dosage
- Administration, Oral - administration & dosage
- Aged, 80 and over - administration & dosage
- Treatment Outcome - administration & dosage
- Hemorrhage - chemically induced
- Time Factors - administration & dosage
- Pacemaker, Artificial - administration & dosage
- Find related publications in this database (Keywords)
- anticoagulation
- atrial fibrillation
- CHA(2)DS(2)-VASc score
- device-detected atrial fibrillation
- NOAH-AFNET 6
- recurrent stroke