A novel risk prediction score in atrial fibrillation for a net clinical outcome from the ENGAGE AF-TIMI 48 randomized clinical trial.

Abstract:

Aims:The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. Methods and results:ENGAGE AF-TIMI 48 was a randomized clinical trial of edoxaban vs. warfarin in 21 105 patients with AF. Cox proportional hazard models identified factors associated with a serious net clinical outcome (NCO) of disabling stroke, life-threatening bleeding, and all-cause mortality in VKA naïve patients from the warfarin arm. These were used to develop an integer risk score. Performance was assessed by C-indices and validation by bootstrapping. Kaplan-Meier analyses were stratified by three score categories and treatment arm. Over a median of 2.7 years, 457 NCO events occurred in 2898 patients with a total person-time of 7549.5 years (6.05%/year). The risk prediction model (C = 0.693) for the NCO was translated into a 17-point integer score, with annualized event rates for the low, intermediate, and high-risk categories in the warfarin arm of 3.5%, 9.9%, and 20.8%, respectively. Therapeutic benefit of higher- and lower-dose edoxaban over warfarin was demonstrated in the high- and intermediate-risk, with equal benefit in the low-risk categories (P-interaction 0.008 and 0.014, respectively). Conclusion:In VKA naive patients with AF, the TIMI-AF score can assist in the prediction of a poor composite outcome and guide selection of anticoagulant therapy by identifying a differential clinical benefit with a NOAC or VKA.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Fanola CL,Giugliano RP,Ruff CT,Trevisan M,Nordio F,Mercuri MF,Antman EM,Braunwald E

doi

10.1093/eurheartj/ehw565

subject

Has Abstract

pub_date

2017-03-21 00:00:00

pages

888-896

issue

12

eissn

0195-668X

issn

1522-9645

pii

ehw565

journal_volume

38

pub_type

杂志文章,多中心研究,随机对照试验
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    doi:

    authors: Nieminen MS,Mattila K,Valtonen V

    更新日期:1993-12-01 00:00:00

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    abstract:Aims:Optimal blood pressure for prevention of cardiovascular (CV) events in patients with Type 2 diabetes mellitus (T2DM) remains uncertain and there is concern for increased risk with low diastolic blood pressure (DBP). This study analysed the association between blood pressure and CV outcomes in high-risk patients wi...

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    更新日期:2018-06-21 00:00:00

  • Prognostic value of tissue inhibitor of metalloproteinase-1 for cardiovascular death among patients with cardiovascular disease: results from the AtheroGene study.

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehi582

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    更新日期:2006-01-01 00:00:00

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    doi:10.1093/eurheartj/5.suppl_c.133

    authors: Gayet JL,Etienne J,Malquarti V,Gruer LD,Didier B,Chuzel M,Champsaur G,Chassignolle J,Fleurette J,Delaye J

    更新日期:1984-10-01 00:00:00

  • Effects of ranolazine on exercise tolerance and HbA1c in patients with chronic angina and diabetes.

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    authors: Timmis AD,Chaitman BR,Crager M

    更新日期:2006-01-01 00:00:00

  • Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry.

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    doi:10.1093/eurheartj/ehl542

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    更新日期:2007-04-01 00:00:00

  • Plasma concentrations of platelet-specific proteins in young female acute myocardial infarction survivors and their age-matched female controls.

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    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a061465

    authors: Kutti J,Johansson S,Eriksson KA,Sigvaldason A,Vedin A,Wadenvik H,Wilhelmsson C

    更新日期:1983-05-01 00:00:00

  • Sensitivity and specificity of pulsed Doppler echocardiography in detection of aortic and mitral regurgitation.

    abstract::In order to assess the value of pulsed Doppler echocardiography in detection of valvular regurgitation, 63 patients were evaluated for aortic and/or mitral regurgitation using pulsed Doppler echocardiography and selective cineangiography. The Doppler study was considered as positive when a turbulent flow was detected ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a061674

    authors: Wautrecht JC,Vandenbossche JL,Englert M

    更新日期:1984-05-01 00:00:00

  • Atorvastatin treatment improves survival and effects of implanted mesenchymal stem cells in post-infarct swine hearts.

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehn167

    authors: Yang YJ,Qian HY,Huang J,Geng YJ,Gao RL,Dou KF,Yang GS,Li JJ,Shen R,He ZX,Lu MJ,Zhao SH

    更新日期:2008-06-01 00:00:00

  • Effects of diuretics on renal excretory function.

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    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/eurheartj/13.suppl_g.15

    authors: Reyes AJ

    更新日期:1992-12-01 00:00:00

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    abstract:BACKGROUND:Recent experimental and clinical data indicate that abnormal central and peripheral immune reactions contribute to the progression of chronic heart failure, and that immunomodulation may be an important therapeutic approach in this syndrome. Aims We sought to study the effects of growth hormone (GH) administ...

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    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0195-668x(03)00480-9

    authors: Adamopoulos S,Parissis JT,Paraskevaidis I,Karatzas D,Livanis E,Georgiadis M,Karavolias G,Mitropoulos D,Degiannis D,Kremastinos DT

    更新日期:2003-12-01 00:00:00

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    pub_type: 杂志文章,评审

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    authors: Gallerani M,Manfredini R,Ricci L,Grandi E,Cappato R,Calò G,Pareschi PL,Fersini C

    更新日期:1992-05-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a060654

    authors: Ståhle E,Bergström R,Holmberg L,Edlund B,Nyström SO,Sjögren I,Hansson HE

    更新日期:1994-09-01 00:00:00

  • Does coronary angioplasty replace, delay, or complement aortocoronary bypass surgery?

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/8.suppl_f.47

    authors: Kaltenbach M

    更新日期:1987-09-01 00:00:00

  • 123I-metaiodobenzylguanidine scintigraphy in the detection of irregular regional sympathetic innervation in long QT syndrome.

    abstract::Twelve patients with the long QT syndrome were studied to determine the usefulness of 123I-metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPECT) at 2 h and 6 h after injection; the results were compared to 10 healthy volunteers (controls). Uptake of MIBG in the left ventricle at 2 h after injection ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/14.3.316

    authors: Müller KD,Jakob H,Neuzner J,Grebe SF,Schlepper M,Pitschner HF

    更新日期:1993-03-01 00:00:00

  • The Extensive Lifestyle Management Intervention (ELMI) following cardiac rehabilitation trial.

    abstract:AIM:Previous studies have reported lifestyle and risk factor deterioration following completion of a cardiac rehabilitation program (CRP). We report the results of a one-year Extensive Lifestyle Management Intervention (ELMI) aimed at preventing these adverse changes. METHODS AND RESULTS:A total of 302 men and women w...

    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.ehj.2003.08.015

    authors: Lear SA,Ignaszewski A,Linden W,Brozic A,Kiess M,Spinelli JJ,Haydn Pritchard P,Frohlich JJ

    更新日期:2003-11-01 00:00:00

  • Transmitral flow velocities and times during stress transthoracic echocardiography in patients with myocardial ischaemia.

    abstract::Twenty-nine men with chronic stable angina pectoris were investigated using stress electrocardiography (ECG) and stress transthoracic echocardiography by means of transoesophageal stimulation of the left atrium. At rest and after each stimulated frequency, ECG and 2-dimensional echocardiography combined with Doppler w...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/14.10.1344

    authors: Meluzín J,Novák M,Julínek J,Rihácek I,Urbánek D,Koukalová H,Toman J

    更新日期:1993-10-01 00:00:00

  • Macrophage NCOR1 protects from atherosclerosis by repressing a pro-atherogenic PPARγ signature.

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehz667

    authors: Oppi S,Nusser-Stein S,Blyszczuk P,Wang X,Jomard A,Marzolla V,Yang K,Velagapudi S,Ward LJ,Yuan XM,Geiger MA,Guillaumon AT,Othman A,Hornemann T,Rancic Z,Ryu D,Oosterveer MH,Osto E,Lüscher TF,Stein S

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  • A double-blind, parallel-group comparison of flosequinan and enalapril in the treatment of chronic heart failure.

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    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/oxfordjournals.eurheartj.a060320

    authors: Silke B,Tennet H,Fischer-Hansen J,Keller N,Heikkila J,Salminen K

    更新日期:1992-08-01 00:00:00

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    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehv008

    authors: Gyberg V,De Bacquer D,Kotseva K,De Backer G,Schnell O,Sundvall J,Tuomilehto J,Wood D,Rydén L,EUROASPIRE IV Investigators.

    更新日期:2015-05-14 00:00:00

  • When should we measure lipoprotein (a)?

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    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/eht053

    authors: Kostner KM,März W,Kostner GM

    更新日期:2013-11-01 00:00:00

  • Effects of lidocaine, procainamide, metoprolol, digoxin and atropine on the conduction of premature ventricular beats in man.

    abstract::The acute electrophysiologic effects of clinical doses of procainamide, lidocaine, metoprolol, digoxin and atropine upon the conduction of ventricular premature beats, were studied in 48 healthy volunteers. The conduction time of the first premature beat, induced 1 ms after the ventricular effective refractory period ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a061755

    authors: Edvardsson N,Hirsch I,Olsson SB

    更新日期:1985-01-01 00:00:00

  • N-terminal brain natriuretic peptide as a screening tool for heart failure in the pacemaker population.

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehi657

    authors: Thackray SD,Witte K,Ghosh J,Nikitin N,Anderson A,Rigby A,Goode K,Clark AL,Cleland JG

    更新日期:2006-02-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehy164

    authors: Lassen MCH,Biering-Sørensen SR,Olsen FJ,Skaarup KG,Tolstrup K,Qasim AN,Møgelvang R,Jensen JS,Biering-Sørensen T

    更新日期:2019-02-07 00:00:00

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehr434

    authors: Szardien S,Nef HM,Voss S,Troidl C,Liebetrau C,Hoffmann J,Rauch M,Mayer K,Kimmich K,Rolf A,Rixe J,Troidl K,Kojonazarov B,Schermuly RT,Kostin S,Elsässer A,Hamm CW,Möllmann H

    更新日期:2012-03-01 00:00:00

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    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/j.ehj.2003.11.016

    authors: Briguori C,Colombo A,Violante A,Balestrieri P,Manganelli F,Paolo Elia P,Golia B,Lepore S,Riviezzo G,Scarpato P,Focaccio A,Librera M,Bonizzoni E,Ricciardelli B

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    journal_title:European heart journal

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    doi:10.1016/j.ehj.2004.02.013

    authors: Zellweger MJ,Hachamovitch R,Kang X,Hayes SW,Friedman JD,Germano G,Pfisterer ME,Berman DS

    更新日期:2004-04-01 00:00:00

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehx106

    authors: Pries AR,Naoum A,Habazettl H,Dunkel M,Preissner R,Coats CJ,Tornada A,Orso F,Van de Werf F,Wood DA,CardioScape steering committee.,Van de Werf F,Wood DA,O'Kelly S,Craven J,Coats A,Sipido K,De Backer D,Wallentin L,Has

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehaa037

    authors: Padang R,Chandrashekar N,Indrabhinduwat M,Scott CG,Luis SA,Chandrasekaran K,Michelena HI,Nkomo VT,Pislaru SV,Pellikka PA,Kane GC

    更新日期:2020-03-21 00:00:00

  • Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting.

    abstract:AIMS:Hitherto, sudden cardiac death in children (SCDc)-defined as sudden cardiac death (SCD) in the 1-18 years old-has been incompletely described in the general population. Knowledge on incidence rates, causes of death and symptoms prior to death is sparse and has been affected by reporting and referral bias. METHODS...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/eht509

    authors: Winkel BG,Risgaard B,Sadjadieh G,Bundgaard H,Haunsø S,Tfelt-Hansen J

    更新日期:2014-04-01 00:00:00