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Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial

Background: We aimed to compare long-term outcomes in Polish patients with atrial fibrillation (AF) according to oral anticoagulation (OAC) type and to evaluate the predictive value of common thromboembolic and bleeding risk scores. Methods: Data from the CRAFT trial (NCT02987062) were included. The...

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Autores principales: Balsam, Paweł, Lodziński, Piotr, Gawałko, Monika, Kraj, Leszek, Śliwczyński, Andrzej, Maciejewski, Cezary, Krzowski, Bartosz, Tymińska, Agata, Ozierański, Krzysztof, Grabowski, Marcin, Bednarski, Janusz, Opolski, Grzegorz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073861/
https://www.ncbi.nlm.nih.gov/pubmed/33921867
http://dx.doi.org/10.3390/jcm10081780
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author Balsam, Paweł
Lodziński, Piotr
Gawałko, Monika
Kraj, Leszek
Śliwczyński, Andrzej
Maciejewski, Cezary
Krzowski, Bartosz
Tymińska, Agata
Ozierański, Krzysztof
Grabowski, Marcin
Bednarski, Janusz
Opolski, Grzegorz
author_facet Balsam, Paweł
Lodziński, Piotr
Gawałko, Monika
Kraj, Leszek
Śliwczyński, Andrzej
Maciejewski, Cezary
Krzowski, Bartosz
Tymińska, Agata
Ozierański, Krzysztof
Grabowski, Marcin
Bednarski, Janusz
Opolski, Grzegorz
author_sort Balsam, Paweł
collection PubMed
description Background: We aimed to compare long-term outcomes in Polish patients with atrial fibrillation (AF) according to oral anticoagulation (OAC) type and to evaluate the predictive value of common thromboembolic and bleeding risk scores. Methods: Data from the CRAFT trial (NCT02987062) were included. The primary study endpoint was major adverse event (MAE; all-cause death, thromboembolic and hemorrhagic event) during the mean four-year follow-up period. Results: Out of 2983 patients with available follow-up data, 1686 (56%) were prescribed with vitamin K antagonist (VKA), 891 (30%) with rivaroxaban and 406 (14%) with dabigatran. Predominance of elderly and female patients with previous history of thromboembolic and hemorrhagic events was observed within rivaroxaban (vs. other OAC) group. Higher rate of MAEs and its components was observed in patients on VKA followed by rivaroxaban as compared to patients on dabigatran (43% vs. 42% vs. 31%, p < 0.01). After group matching based on clinical characteristics, higher risk of hemorrhagic events in VKA (vs. dabigatran) and rivaroxaban (vs. dabigatran) group were observed. The available thromboembolic (CHA(2)DS(2)-VASs, ATRIA, R(2)CHADS(2)) and bleeding (HAS-BLED, ATRIA, ORBIT) risk scores showed poor prediction value. Conclusions: Despite no difference in the thromboembolic event rate, treatment with VKA and rivaroxaban was associated with a significant increase in the risk of hemorrhagic events.
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spelling pubmed-80738612021-04-27 Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial Balsam, Paweł Lodziński, Piotr Gawałko, Monika Kraj, Leszek Śliwczyński, Andrzej Maciejewski, Cezary Krzowski, Bartosz Tymińska, Agata Ozierański, Krzysztof Grabowski, Marcin Bednarski, Janusz Opolski, Grzegorz J Clin Med Article Background: We aimed to compare long-term outcomes in Polish patients with atrial fibrillation (AF) according to oral anticoagulation (OAC) type and to evaluate the predictive value of common thromboembolic and bleeding risk scores. Methods: Data from the CRAFT trial (NCT02987062) were included. The primary study endpoint was major adverse event (MAE; all-cause death, thromboembolic and hemorrhagic event) during the mean four-year follow-up period. Results: Out of 2983 patients with available follow-up data, 1686 (56%) were prescribed with vitamin K antagonist (VKA), 891 (30%) with rivaroxaban and 406 (14%) with dabigatran. Predominance of elderly and female patients with previous history of thromboembolic and hemorrhagic events was observed within rivaroxaban (vs. other OAC) group. Higher rate of MAEs and its components was observed in patients on VKA followed by rivaroxaban as compared to patients on dabigatran (43% vs. 42% vs. 31%, p < 0.01). After group matching based on clinical characteristics, higher risk of hemorrhagic events in VKA (vs. dabigatran) and rivaroxaban (vs. dabigatran) group were observed. The available thromboembolic (CHA(2)DS(2)-VASs, ATRIA, R(2)CHADS(2)) and bleeding (HAS-BLED, ATRIA, ORBIT) risk scores showed poor prediction value. Conclusions: Despite no difference in the thromboembolic event rate, treatment with VKA and rivaroxaban was associated with a significant increase in the risk of hemorrhagic events. MDPI 2021-04-19 /pmc/articles/PMC8073861/ /pubmed/33921867 http://dx.doi.org/10.3390/jcm10081780 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Balsam, Paweł
Lodziński, Piotr
Gawałko, Monika
Kraj, Leszek
Śliwczyński, Andrzej
Maciejewski, Cezary
Krzowski, Bartosz
Tymińska, Agata
Ozierański, Krzysztof
Grabowski, Marcin
Bednarski, Janusz
Opolski, Grzegorz
Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial
title Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial
title_full Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial
title_fullStr Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial
title_full_unstemmed Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial
title_short Antithrombotic Management and Long-Term Outcomes of Patients with Atrial Fibrillation. Insights from CRAFT Trial
title_sort antithrombotic management and long-term outcomes of patients with atrial fibrillation. insights from craft trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073861/
https://www.ncbi.nlm.nih.gov/pubmed/33921867
http://dx.doi.org/10.3390/jcm10081780
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