echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Study of Nervous System > Patients with atrial fibrillation are at high risk of bleeding. How to prevent stroke?

    Patients with atrial fibrillation are at high risk of bleeding. How to prevent stroke?

    • Last Update: 2022-06-02
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

    For medical professionals to read and refer to clinical information only, long-term oral anticoagulants (OACs) are necessary measures to prevent stroke in patients with atrial fibrillation (AF)
    .

    But is very low-dose edoxaban (15 mg daily) safe and effective for stroke prevention in patients 80 to 90 years of age who are ineligible for standard-dose oral anticoagulants because of high bleeding risk? A study from JAMA Cardiology examined very low-dose edoxaban (15 mg) versus placebo in 3 age groups (80 to 84 years, 85 to 89 years old) and ≥90 years of age) in patients with atrial fibrillation
    .

    How is this research done? The study, conducted from August 5, 2016 to December 27, 2019, randomly recruited 984 patients with atrial fibrillation aged 80 years and older who were not considered candidates for standard-dose OACs from 164 hospitals in Japan.
    Patients [Mean (SD) age: 80-84 year old age group, 82.
    2 (1.
    4) years old; 85-89 year old age group, 86.
    8 (1.
    4) years old; ≥90 year old age group, 92.
    3 (2.
    1) years old; 565 women (57.
    4%)], randomized 1:1 to edoxaban or placebo
    .

    The main reasons why such patients cannot take standard doses of OACs are: low creatinine clearance (<30mL/min), low body weight (≤45kg), history of bleeding in vital organs, continuous use of non-steroidal anti-inflammatory drugs or concomitant use of antiplatelet drugs drug
    .

    The primary efficacy endpoint was a composite of stroke or systemic embolism
    .

    The primary safety endpoint was major bleeding as defined by the International Society of Thrombosis and Hemostasis
    .

    MAIN STUDY CONCLUSIONS The estimated (SE) event rate for stroke or systemic embolism increased with age in the placebo group; in the 80-84 year group (n=181), it was 3.
    9% per patient per year ( 1.
    2%); in the 85-89 age group (n=184), 7.
    3% (1.
    7%) per patient-year; in the ≥90-year-old age group (n=127), 10.
    1% (2.
    5%) per patient-year %)
    .

    The results of the edoxaban group showed that the incidence of stroke or systemic embolism continued to be reduced after treatment with no interaction with age (80-84 years, HR, 0.
    41; 95% CI, 0.
    13-1.
    31; P=0.
    13; 85-89 years, HR, 0.
    42; 95%CI, 0.
    17-0.
    99; P=0.
    05; ≥90 years, HR, 0.
    23; 95%CI, 0.
    08-0.
    68; P=0.
    008; P=0.
    65 for interaction)
    .

    The number of major bleeding and major clinically relevant, non-major bleeding events was higher with edoxaban, but the difference did not reach statistical significance and there was no interaction with age
    .

    Across all age groups, there was no difference in all-cause mortality between the edoxaban and placebo groups
    .

    In conclusion, in Japanese AF patients 80 years and older who are not considered candidates for standard OACs, edoxaban 15 mg once daily was effective in all 3 age groups (including 90 years and older), It was consistently shown to be superior to placebo in preventing stroke or systemic embolism
    .

    Although the incidence of edoxaban-related bleeding was higher, it was not statistically significant
    .

    ▎How to track more popular clinical information? There are so many journals and magazines, I want to see them, but clinical work is too busy, how can I not miss key clinical information? Corey came to me to share literature again.
    Which literature is worth talking about? Have to ask the brothers and sisters and the director? After studying medicine for many years, can vitamin D reduce dementia? Sitting for long periods of time hurts your body and your kidneys? Does lack of sleep cause death sooner? Where can I find these vital clinical information? The assistant of the top journals of the clinical literature is online👇1.
    Scan the QR code below the QR code to jump to the H5 page of "Top Journal Essentials" 2.
    Click "Download Now" 3.
    Open the Doctor Station App and click the column 4.
    Use the clinical medication Find the "Top Issues Essentials" follow column and subscribe to the column, and read a new top issue every day! Download the Doctor Station App and subscribe anytime, anywhere~ References: [1] Kuroda M, Tamiya E, Nose T, Ogimoto A, Taura J, Imamura Y, Fukuzawa M, Hayashi T, Akao M, Yamashita T, Lip GYH, Okumura K.
    Effect of 15-mg Edoxaban on Clinical Outcomes in 3 Age Strata in Older Patients With Atrial Fibrillation:A Prespecified Subanalysis of the ELDERCARE-AF Randomized Clinical Trial.
    JAMA Cardiol.
    2022 Apr 13.
    doi:10.
    1001/jamacardio.
    2022.
    0480.
    Epub ahead of print.
    PMID:35416910.
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.