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Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h

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Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h. / Becher, Nina; Toennis, Tobias; Bertaglia, Emanuele; Blomstrom Lundqvist, Carina; Brandes, Axel; Cabanelas, Nuno; Calvert, Melanie; Camm, A. John; Chlouverakis, Gregory; Dan, Gheorghe-Andrei; Dichtl, Wolfgang; Diener, Hans-Christoph; Fierenz, Alexander; Goette, Andreas; de Groot, Joris R.; N L Hermans, Astrid ; Lip, Gregory Y.H.; Lubiński, Andrzej; Marijon, Eloi; Merkely, Béla; Mont, Lluís; Ozga, Ann-Kathrin; Rajappan, Kim; Sarkozy, Andrea; Scherr, Daniel; Schnabel, Renate; Schotten, Ulrich; Sehner, Susanne; Simantirakis, Emmanuel; Vardas, Panos; Velchev, Vasil; Wichterle, Dan; Zapf, Antonia; Kirchhof, Paulus; NOAH-AFNET 6 Investigators.

In: EUR HEART J, Vol. 45, No. 10, ehad771, 07.03.2024, p. 837-849.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Becher, N, Toennis, T, Bertaglia, E, Blomstrom Lundqvist, C, Brandes, A, Cabanelas, N, Calvert, M, Camm, AJ, Chlouverakis, G, Dan, G-A, Dichtl, W, Diener, H-C, Fierenz, A, Goette, A, de Groot, JR, N L Hermans, A, Lip, GYH, Lubiński, A, Marijon, E, Merkely, B, Mont, L, Ozga, A-K, Rajappan, K, Sarkozy, A, Scherr, D, Schnabel, R, Schotten, U, Sehner, S, Simantirakis, E, Vardas, P, Velchev, V, Wichterle, D, Zapf, A, Kirchhof, P & NOAH-AFNET 6 Investigators 2024, 'Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h', EUR HEART J, vol. 45, no. 10, ehad771, pp. 837-849. https://doi.org/10.1093/eurheartj/ehad771

APA

Becher, N., Toennis, T., Bertaglia, E., Blomstrom Lundqvist, C., Brandes, A., Cabanelas, N., Calvert, M., Camm, A. J., Chlouverakis, G., Dan, G-A., Dichtl, W., Diener, H-C., Fierenz, A., Goette, A., de Groot, J. R., N L Hermans, A., Lip, G. Y. H., Lubiński, A., Marijon, E., ... NOAH-AFNET 6 Investigators (2024). Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h. EUR HEART J, 45(10), 837-849. [ehad771]. https://doi.org/10.1093/eurheartj/ehad771

Vancouver

Becher N, Toennis T, Bertaglia E, Blomstrom Lundqvist C, Brandes A, Cabanelas N et al. Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h. EUR HEART J. 2024 Mar 7;45(10):837-849. ehad771. https://doi.org/10.1093/eurheartj/ehad771

Bibtex

@article{ba9965f923934dfa9e0d73eb913edd19,
title = "Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h",
abstract = "BACKGROUND AND AIMS: Patients with long atrial high-rate episodes (AHREs) ≥24 h and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared with no anticoagulation in these patients.METHODS: This secondary pre-specified analysis of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High-rate episodes (NOAH-AFNET 6) trial examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared with placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and electrocardiogram (ECG)-diagnosed atrial fibrillation.RESULTS: Median follow-up of 2389 patients with core lab-verified AHRE was 1.8 years. AHRE ≥24 h were present at baseline in 259/2389 patients (11%, 78 ± 7 years old, 28% women, CHA2DS2-VASc 4). Clinical characteristics were not different from patients with shorter AHRE. The primary outcome occurred in 9/132 patients with AHRE ≥24 h (4.3%/patient-year, 2 strokes) treated with anticoagulation and in 14/127 patients treated with placebo (6.9%/patient-year, 2 strokes). Atrial high-rate episode duration did not interact with the efficacy (P-interaction = .65) or safety (P-interaction = .98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE ≥24 h developed more ECG-diagnosed atrial fibrillation (17.0%/patient-year) than patients with shorter AHRE (8.2%/patient-year; P < .001).CONCLUSIONS: This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.",
author = "Nina Becher and Tobias Toennis and Emanuele Bertaglia and {Blomstrom Lundqvist}, Carina and Axel Brandes and Nuno Cabanelas and Melanie Calvert and Camm, {A. John} and Gregory Chlouverakis and Gheorghe-Andrei Dan and Wolfgang Dichtl and Hans-Christoph Diener and Alexander Fierenz and Andreas Goette and {de Groot}, {Joris R.} and {N L Hermans}, Astrid and Lip, {Gregory Y.H.} and Andrzej Lubi{\'n}ski and Eloi Marijon and B{\'e}la Merkely and Llu{\'i}s Mont and Ann-Kathrin Ozga and Kim Rajappan and Andrea Sarkozy and Daniel Scherr and Renate Schnabel and Ulrich Schotten and Susanne Sehner and Emmanuel Simantirakis and Panos Vardas and Vasil Velchev and Dan Wichterle and Antonia Zapf and Paulus Kirchhof and {NOAH-AFNET 6 Investigators}",
year = "2024",
month = mar,
day = "7",
doi = "https://doi.org/10.1093/eurheartj/ehad771",
language = "English",
volume = "45",
pages = "837--849",
journal = "EUR HEART J",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "10",

}

RIS

TY - JOUR

T1 - Anticoagulation with edoxaban in patients with long atrial high-rate episodes ≥24 h

AU - Becher, Nina

AU - Toennis, Tobias

AU - Bertaglia, Emanuele

AU - Blomstrom Lundqvist, Carina

AU - Brandes, Axel

AU - Cabanelas, Nuno

AU - Calvert, Melanie

AU - Camm, A. John

AU - Chlouverakis, Gregory

AU - Dan, Gheorghe-Andrei

AU - Dichtl, Wolfgang

AU - Diener, Hans-Christoph

AU - Fierenz, Alexander

AU - Goette, Andreas

AU - de Groot, Joris R.

AU - N L Hermans, Astrid

AU - Lip, Gregory Y.H.

AU - Lubiński, Andrzej

AU - Marijon, Eloi

AU - Merkely, Béla

AU - Mont, Lluís

AU - Ozga, Ann-Kathrin

AU - Rajappan, Kim

AU - Sarkozy, Andrea

AU - Scherr, Daniel

AU - Schnabel, Renate

AU - Schotten, Ulrich

AU - Sehner, Susanne

AU - Simantirakis, Emmanuel

AU - Vardas, Panos

AU - Velchev, Vasil

AU - Wichterle, Dan

AU - Zapf, Antonia

AU - Kirchhof, Paulus

AU - NOAH-AFNET 6 Investigators

PY - 2024/3/7

Y1 - 2024/3/7

N2 - BACKGROUND AND AIMS: Patients with long atrial high-rate episodes (AHREs) ≥24 h and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared with no anticoagulation in these patients.METHODS: This secondary pre-specified analysis of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High-rate episodes (NOAH-AFNET 6) trial examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared with placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and electrocardiogram (ECG)-diagnosed atrial fibrillation.RESULTS: Median follow-up of 2389 patients with core lab-verified AHRE was 1.8 years. AHRE ≥24 h were present at baseline in 259/2389 patients (11%, 78 ± 7 years old, 28% women, CHA2DS2-VASc 4). Clinical characteristics were not different from patients with shorter AHRE. The primary outcome occurred in 9/132 patients with AHRE ≥24 h (4.3%/patient-year, 2 strokes) treated with anticoagulation and in 14/127 patients treated with placebo (6.9%/patient-year, 2 strokes). Atrial high-rate episode duration did not interact with the efficacy (P-interaction = .65) or safety (P-interaction = .98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE ≥24 h developed more ECG-diagnosed atrial fibrillation (17.0%/patient-year) than patients with shorter AHRE (8.2%/patient-year; P < .001).CONCLUSIONS: This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.

AB - BACKGROUND AND AIMS: Patients with long atrial high-rate episodes (AHREs) ≥24 h and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared with no anticoagulation in these patients.METHODS: This secondary pre-specified analysis of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High-rate episodes (NOAH-AFNET 6) trial examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared with placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and electrocardiogram (ECG)-diagnosed atrial fibrillation.RESULTS: Median follow-up of 2389 patients with core lab-verified AHRE was 1.8 years. AHRE ≥24 h were present at baseline in 259/2389 patients (11%, 78 ± 7 years old, 28% women, CHA2DS2-VASc 4). Clinical characteristics were not different from patients with shorter AHRE. The primary outcome occurred in 9/132 patients with AHRE ≥24 h (4.3%/patient-year, 2 strokes) treated with anticoagulation and in 14/127 patients treated with placebo (6.9%/patient-year, 2 strokes). Atrial high-rate episode duration did not interact with the efficacy (P-interaction = .65) or safety (P-interaction = .98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE ≥24 h developed more ECG-diagnosed atrial fibrillation (17.0%/patient-year) than patients with shorter AHRE (8.2%/patient-year; P < .001).CONCLUSIONS: This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.

U2 - https://doi.org/10.1093/eurheartj/ehad771

DO - https://doi.org/10.1093/eurheartj/ehad771

M3 - SCORING: Journal article

C2 - 37956458

VL - 45

SP - 837

EP - 849

JO - EUR HEART J

JF - EUR HEART J

SN - 0195-668X

IS - 10

M1 - ehad771

ER -