Direct Current Cardioversion in Atrial Fibrillation Patients on Edoxaban Therapy Versus Vitamin K Antagonists: a Real-world Propensity Score–Matched Study

Autor: Anna Rago, Emilio Attena, Andrea Antonio Papa, Vincenzo Russo, Valentina Parisi, Paolo Golino, Gerardo Nigro
Přispěvatelé: Rago, A., Papa, A. A., Attena, E., Parisi, V., Golino, P., Nigro, G., Russo, V.
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Vitamin K
Pyridines
medicine.medical_treatment
Pyridine
Embolism
030204 cardiovascular system & hematology
Cardioversion
Uninterrupted vitamin K antagonists
chemistry.chemical_compound
0302 clinical medicine
Edoxaban
Transesophageal echocardiogram
Medicine
Pharmacology (medical)
Cumulative incidence
030212 general & internal medicine
Direct electrical current cardioversion
Stroke
Aged
80 and over
Atrial fibrillation
General Medicine
Vitamin K antagonist
Middle Aged
Ischemic Attack
Transient
Cohort
Original Article
Female
Uninterrupted vitamin K antagonist
Cardiology and Cardiovascular Medicine
Human
medicine.medical_specialty
medicine.drug_class
Electric Countershock
Hemorrhage
Medication Adherence
03 medical and health sciences
Internal medicine
Humans
Propensity Score
Aged
Pharmacology
business.industry
medicine.disease
Discontinuation
Thiazoles
chemistry
Thiazole
business
Factor Xa Inhibitor
Factor Xa Inhibitors
Zdroj: Cardiovascular Drugs and Therapy
ISSN: 1573-7241
0920-3206
Popis: Purpose The purpose of the present study was to compare the long-term effectiveness and safety of newly initiated anticoagulation with edoxaban (EDO) versus uninterrupted vitamin K antagonist (VKA) therapy in patients with atrial fibrillation (AF) scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC). Methods A propensity score-matched cohort observational study was performed comparing the safety and effectiveness of edoxaban versus well-controlled VKA therapy among a cohort of consecutive non-valvular AF patients scheduled for DCC. The primary safety outcome was major bleeding. The primary efficacy outcome was the composite of stroke, transient ischemic attack (TIA), and systemic embolism (SE). Findings A total of 130 AF patients receiving edoxaban 60-mg (EDO) treatment were compared with the same number of VKA recipients. The cumulative incidence of major bleedings was 1.54% in the EDO group and 3.08% in the VKA group (P = 0.4). The cumulative incidence of thromboembolic events was 1.54% in the EDO group and 2.31% in the VKA group (P = 0.9). A non-significant trend in improved adherence was observed between the EDO and VKA groups with a total anticoagulant therapy discontinuation rate of 4.62% (6/130) vs 6.15% (8/130), respectively (P = 0.06). Implications Our study provides the evidence of a safe and effective use of edoxaban in this clinical setting, justified by no significant difference in major bleedings and thromboembolic events between edoxaban and well-controlled VKA treatments.
Databáze: OpenAIRE
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