A randomized comparison of two direct oral anticoagulants for patients undergoing cardiac ablation with a contemporary warfarin control arm
Autor: | Naoya Oketani, Issei Yoshimoto, Hitoshi Ichiki, Hideki Okui, Masaaki Miyata, Yasuhisa Iriki, Fuminori Namino, Mitsuru Ohishi, Ryuichi Maenosono |
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Rok vydání: | 2020 |
Předmět: |
Male
Administration Oral 030204 cardiovascular system & hematology Hemopericardium Asymptomatic 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Rivaroxaban Edoxaban Physiology (medical) Atrial Fibrillation medicine Humans Prospective Studies 030212 general & internal medicine Stroke business.industry Incidence (epidemiology) Warfarin Anticoagulants Atrial fibrillation medicine.disease chemistry Anesthesia Catheter Ablation medicine.symptom Cardiology and Cardiovascular Medicine business Factor Xa Inhibitors medicine.drug |
Zdroj: | Journal of Interventional Cardiac Electrophysiology. 60:375-385 |
ISSN: | 1572-8595 1383-875X |
DOI: | 10.1007/s10840-020-00732-y |
Popis: | The safety and efficacy of periprocedural use of direct oral anticoagulants (DOACs) for atrial fibrillation (AF) remain unclear. We compared the incidence of asymptomatic cerebral micro-thromboembolism and hemopericardium following AF ablation among patients receiving edoxaban, rivaroxaban, and warfarin and between normal- and low-dose use of edoxaban and rivaroxaban. This prospective randomized study included 170 consecutive AF patients. Patients taking DOACs upon admission to our hospital were randomly assigned to an edoxaban group or to a rivaroxaban group. Warfarin was continued in patients receiving warfarin at admission. All patients underwent AF ablation, and cerebral MRI was performed to evaluate asymptomatic cerebral micro-thromboembolism the day after the procedure. Sixty-one patients were assigned to edoxaban and 63 to rivaroxaban. Warfarin was continued in 46 patients. Although asymptomatic cerebral micro-thromboembolism was detected in 25 patients (16.3%), there were no significant differences among the groups. Hemopericardium occurred in 2 patients (one each in the rivaroxaban and warfarin groups). The incidence of asymptomatic cerebral micro-thromboembolism was higher in the low-dose group (9 patients, 25.7%) than in the normal-dose group (8 patients, 10.0%) for patients prescribed either edoxaban or rivaroxaban (p |
Databáze: | OpenAIRE |
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