Edoxaban for stroke prevention in atrial fibrillation and age-adjusted predictors of clinical outcomes in routine clinical care
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Edoxaban for stroke prevention in atrial fibrillation and age-adjusted predictors of clinical outcomes in routine clinical care. / Kirchhof, Paulus; Pecen, Ladislav; Bakhai, Ameet; de Asmundis, Carlo; de Groot, Joris R; Deharo, Jean Claude; Kelly, Peter; Levy, Pierre; Lopez-de-Sa, Esteban; Monteiro, Pedro; Steffel, Jan; Waltenberger, Johannes; Weiss, Thomas W; Laeis, Petra; Manu, Marius Constantin; Souza, José; De Caterina, Raffaele.
in: EUR HEART J-CARD PHA, Jahrgang 9, Nr. 1, 15.12.2022, S. 47-57.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Edoxaban for stroke prevention in atrial fibrillation and age-adjusted predictors of clinical outcomes in routine clinical care
AU - Kirchhof, Paulus
AU - Pecen, Ladislav
AU - Bakhai, Ameet
AU - de Asmundis, Carlo
AU - de Groot, Joris R
AU - Deharo, Jean Claude
AU - Kelly, Peter
AU - Levy, Pierre
AU - Lopez-de-Sa, Esteban
AU - Monteiro, Pedro
AU - Steffel, Jan
AU - Waltenberger, Johannes
AU - Weiss, Thomas W
AU - Laeis, Petra
AU - Manu, Marius Constantin
AU - Souza, José
AU - De Caterina, Raffaele
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022/12/15
Y1 - 2022/12/15
N2 - AIMS: Patients with atrial fibrillation (AF) treated with oral anticoagulation still suffer from cardiovascular complications including cardiovascular death, stroke, and major bleeding. To identify risk factors for predicting stroke and bleeding outcomes in anticoagulated patients, we assessed 2-year outcomes in patients with AF treated with edoxaban in routine care. We also report the age-adjusted risk predictors of clinical outcomes.METHODS AND RESULTS: The Edoxaban Treatment in Routine Clinical Practice for Patients With Non-Valvular Atrial Fibrillation (ETNA-AF) Europe (NCT02944019) is a prospective, multi-centre, post-authorisation, observational study with an overall 4-year follow-up conducted in 825 centres enrolling edoxaban-treated patients in 10 European countries. Of the 13 133 patients with AF (mean age: 73.6 ± 9.5 years), 5682 (43.3%) were female. At the 2-year follow-up, 9017/13 133 patients were still on edoxaban; 1830 discontinued treatment including 937 who died (annualised event rate of all-cause death was 3.87%). 518 (2.14%) patients died of cardiovascular causes; 234 (0.97%) experienced major bleeding and 168 (0.70%) experienced stroke or systemic embolic events (SEE). Intracranial haemorrhage was noted in 49 patients (0.20%). History of transient ischaemic attack (TIA) at baseline was the strongest predictor of ischaemic stroke or SEE (Wald χ2: 73.63; P < 0.0001). Low kidney function at baseline was the strongest predictor of major bleeding (Wald χ2: 30.68; P < 0.0001). History of heart failure (HF) was the strongest predictor of all-cause (Wald χ2: 146.99; P < 0.0001) and cardiovascular death (Wald χ2: 100.38; P < 0.0001).CONCLUSION: Patients treated with edoxaban in ETNA-AF-Europe reported low 2-year event rates in unselected AF patients. Prior stroke, reduced kidney function, and HF identify patients at high risk of stroke, bleeding and all-cause/cardiovascular death, respectively.
AB - AIMS: Patients with atrial fibrillation (AF) treated with oral anticoagulation still suffer from cardiovascular complications including cardiovascular death, stroke, and major bleeding. To identify risk factors for predicting stroke and bleeding outcomes in anticoagulated patients, we assessed 2-year outcomes in patients with AF treated with edoxaban in routine care. We also report the age-adjusted risk predictors of clinical outcomes.METHODS AND RESULTS: The Edoxaban Treatment in Routine Clinical Practice for Patients With Non-Valvular Atrial Fibrillation (ETNA-AF) Europe (NCT02944019) is a prospective, multi-centre, post-authorisation, observational study with an overall 4-year follow-up conducted in 825 centres enrolling edoxaban-treated patients in 10 European countries. Of the 13 133 patients with AF (mean age: 73.6 ± 9.5 years), 5682 (43.3%) were female. At the 2-year follow-up, 9017/13 133 patients were still on edoxaban; 1830 discontinued treatment including 937 who died (annualised event rate of all-cause death was 3.87%). 518 (2.14%) patients died of cardiovascular causes; 234 (0.97%) experienced major bleeding and 168 (0.70%) experienced stroke or systemic embolic events (SEE). Intracranial haemorrhage was noted in 49 patients (0.20%). History of transient ischaemic attack (TIA) at baseline was the strongest predictor of ischaemic stroke or SEE (Wald χ2: 73.63; P < 0.0001). Low kidney function at baseline was the strongest predictor of major bleeding (Wald χ2: 30.68; P < 0.0001). History of heart failure (HF) was the strongest predictor of all-cause (Wald χ2: 146.99; P < 0.0001) and cardiovascular death (Wald χ2: 100.38; P < 0.0001).CONCLUSION: Patients treated with edoxaban in ETNA-AF-Europe reported low 2-year event rates in unselected AF patients. Prior stroke, reduced kidney function, and HF identify patients at high risk of stroke, bleeding and all-cause/cardiovascular death, respectively.
KW - Humans
KW - Female
KW - Middle Aged
KW - Aged
KW - Aged, 80 and over
KW - Male
KW - Atrial Fibrillation/complications
KW - Stroke/diagnosis
KW - Factor Xa Inhibitors
KW - Brain Ischemia/prevention & control
KW - Anticoagulants/adverse effects
KW - Prospective Studies
KW - Treatment Outcome
KW - Hemorrhage/chemically induced
KW - Embolism
KW - Heart Failure/drug therapy
U2 - 10.1093/ehjcvp/pvac042
DO - 10.1093/ehjcvp/pvac042
M3 - SCORING: Journal article
C2 - 35881467
VL - 9
SP - 47
EP - 57
JO - EUR HEART J-CARD PHA
JF - EUR HEART J-CARD PHA
SN - 2055-6837
IS - 1
ER -