Abstract:
BACKGROUND:Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS:The ORBIT-AF II study is a national, US, prospective, observational, cohort study of anticoagulation treatment in patients with AF receiving NOACs or warfarin in the United States from 2013 to 2016. We measured factors associated with oral anticoagulant selection in 4,670 patients recently diagnosed with AF. RESULTS:At baseline, 1,169 (25%) patients were started on warfarin and 3,501 (75%) on NOACs: of these latter, 259 (6%) were started on dabigatran, 1858 (40%) on rivaroxaban, and 1384 (30%) on apixaban. Those receiving NOACs were slightly younger patients (median age 71 vs 72, P<.0001); were less likely to have prior stroke (5.3% vs 8.6%; P<.0001) or prior bleeding (2.7% vs 4.4%; P=.005); had better kidney function (mean estimated glomerular filtration rate 91 mL/min vs 80 mL/min, P<.0001); and had fewer patients at high stroke risk (CHA2DS2-VASc score [Congestive heart failure, Hypertension, Age ≥75years, Diabetes mellitus, Prior stroke, transient ischemic attack {TIA}, or thromboembolism,Vascular disease, Age 65-74years, Sex category {female}] ≥2 in 86% vs 93%; P<.0001). In multivariable analysis, factors associated with NOAC selection versus warfarin included renal function, prior stroke or valve replacement, rhythm control AF management strategy, treatment by a cardiologist, and higher patient education level. CONCLUSIONS:In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT01701817.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Steinberg BA,Shrader P,Thomas L,Ansell J,Fonarow GC,Gersh BJ,Hylek E,Kowey PR,Mahaffey KW,O'Brien EC,Singer DE,Peterson ED,Piccini JP,Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Investigatodoi
10.1016/j.ahj.2017.03.024subject
Has Abstractpub_date
2017-07-01 00:00:00pages
40-47eissn
0002-8703issn
1097-6744pii
S0002-8703(17)30119-9journal_volume
189pub_type
临床试验,杂志文章,多中心研究abstract:BACKGROUND:Balloon inflation during coronary angioplasty results in shear stress-induced vessel wall injury with development of restenosis. This randomized trial compared the impact of two different balloon inflation strategies (slow versus fast) on restenosis after coronary angioplasty. METHODS:Two hundred seven pati...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(98)70290-x
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Analyses of country or regional differences in cardiovascular (CV) trials are based on geographical subgroup analyses. However, apart from map location and related racial, ethnic, and genetic variations, identified differences may also depend on social structure and provision and access to health care, for w...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2019.08.019
更新日期:2019-12-01 00:00:00
abstract::To investigate the significance and mechanism of dilatation of the left ventricular cavity on dipyridamole thallium-201 imaging, we performed both dipyridamole thallium-201 imaging and dipyridamole radionuclide angiography on 83 patients with known angiograms. The dipyridamole/delayed ratio of the left ventricular dim...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90713-r
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Physician adherence to guidelines is often poor, but the reasons have not been completely studied. We investigated whether physician adherence to guidelines for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) varied by source, development methods, or the exten...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2003.35
更新日期:2003-01-01 00:00:00
abstract::The extent and time course of recovery of left ventricular function were investigated in 29 patients with no previous symptoms who had acute nonischemic congestive cardiomyopathy and left ventricular ejection fraction of 0.22 +/- 0.07. Improvement in left ventricular ejection fraction by at least 0.05 was observed in ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90038-1
更新日期:1995-01-01 00:00:00
abstract::We developed a logistic regression model with data from the GUSTO-I trial to predict mortality rate differences in individual patients who received accelerated tissue plasminogen activator (TPA) versus streptokinase treatment for acute myocardial infarction. A nomogram was developed from a reduced version of this mode...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(97)70164-9
更新日期:1997-06-01 00:00:00
abstract::To assess the effects of chronic left ventricular (LV) dysfunction on intravascular pulmonary blood volume (PBV) and extravascular lung water (EVLW) lung fluid volumes, 56 dogs were evaluated by means of double-indicator dilution techniques. PBV and EVLW were measured in seven control dogs, in eight dogs 4 hours after...
journal_title:American heart journal
pub_type: 杂志文章,收录出版
doi:10.1016/0002-8703(84)90421-6
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Despite the known benefits of cardiac rehabilitation in patients with coronary artery disease, referral rates to rehabilitation programs remain low. We determined the incidence and determinants of cardiac rehabilitation referral rates for patients undergoing percutaneous coronary intervention (PCI). METHODS...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2010.11.016
更新日期:2011-03-01 00:00:00
abstract::Short-term follow-up after percutaneous aortic balloon valvuloplasty shows a high incidence of restenosis. Yet a high percentage of patients with restenosis continue to show symptomatic improvement. Those with decreased left ventricular function originally tend to have a recurrence of symptoms. In this study Doppler-d...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)91028-y
更新日期:1992-05-01 00:00:00
abstract::To assess the influence of viscosity and iodine concentration, three matched and standardized left coronary arteriograms were obtained in 20 patients using iopamidol (Isovue-370), ioversol (Optiray-320), and iohexol (Omnipaque-350). The order of contrast media was randomized and the administration of contrast was doub...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(92)90760-s
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Pulmonary vein antrum isolation (PVI) as a treatment of paroxysmal atrial fibrillation (AF) is associated with a high rate of success; however, outcomes for treating persistent and long-standing persistent AF with PVI alone are substantially lower and often require multiple procedures to maintain long-term f...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.09.019
更新日期:2015-12-01 00:00:00
abstract::To estimate the incidence of residual atrial septal perforation (ASP) following percutaneous transvenous mitral commissurotomy (PTMC) with the Inoue balloon catheter and to examine the factors contributing to ASP, we studied 46 patients with mitral stenosis undergoing PTMC. Residual ASP was evaluated by Doppler color ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90203-a
更新日期:1990-10-01 00:00:00
abstract::Two patients with isolated T wave alternans are reported, with their vectocardiograms, their response to carotid sinus stimulation, and the response to calcium infusion in one of them with documented severe hypocalcemia. Eleven cases of the literature are briefly reviewed. The alternans of the T wave appears with seve...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90369-1
更新日期:1978-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare rate of onset, magnitude, and consistency of platelet inhibition after administration of prasugrel or clopidogrel and to relate platelet inhibition to systemic exposure to each active metabolite. Thienopyridines are prodrugs, metabolized in vivo to active metabolites that...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2006.10.010
更新日期:2007-01-01 00:00:00
abstract::This study examines the electrophysiologic effects of an intravenous bolus of lidocaine in the normal canine ventricle. In 14 open-chest dogs, left ventricular effective refractory period, ventricular repolarization time, and activation time were measured continuously during ventricular pacing (150/min) before, during...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(85)90559-9
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:High-intensity interval training has been shown to be superior to moderate continuous exercise training in improving exercise capacity and endothelial function in patients with coronary artery disease. The objective of this study was to evaluate this training model on in-stent restenosis following percutaneo...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.08.021
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Although prior studies have demonstrated disparities in the management and outcomes of women with acute coronary syndrome (ACS), there are limited large-scale contemporary data on gender differences in post-intervention outcomes in this population. METHODS:We analyzed patients according to 2 ACS categories,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.08.012
更新日期:2009-01-01 00:00:00
abstract::Selective blockade of the angiotensin II AT1 receptor represents a novel mechanism for interrupting the renin-angiotensin system without altering the potential benefits of AT2 receptor stimulation. This selective inhibition produces none of the disadvantages associated with reduced bradykinin metabolism and angiotensi...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70317-0
更新日期:1999-09-01 00:00:00
abstract::Over the past 11 years, a considerable body of evidence has accumulated implicating defects in the mitochondrial energy-generating pathway, oxidative phosphorylation, in a wide variety of degenerative diseases including myopathy and cardiomyopathy. Most classes of pathogenic mitochondrial DNA mutations affect the hear...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1067/mhj.2000.103934
更新日期:2000-02-01 00:00:00
abstract::Three cases of large multiple coronary aneurysms, situated on both right and left coronary arteries, were seen in three middle-aged adult patients. These patients were hospitalized for myocardial infarction in two cases and for angina pectoris in the third case. On the coronary angiogram, the coronary lesions were qui...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90617-1
更新日期:1980-06-01 00:00:00
abstract::To evaluate the risk factors for coronary disease, 345 women, aged 35 to 59 years, who had undergone coronary arteriography for suspected coronary disease completed a mail questionnaire, telephone interview, or both. Two hundred eight women with angiographically normal coronary arteries constituted the control group, ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(89)90398-0
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:P2Y12 receptor antagonist therapy is recommended in addition to ASA for up to 1 year after acute coronary syndrome to reduce ischemic events. In contrast, the benefit of long-term dual antiplatelet therapy beyond 1 year remains unclear. Ticagrelor is a potent, reversibly binding P2Y12 receptor-antagonist tha...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2013.12.020
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The rise in cardiac troponin I after ST-elevation myocardial infarction treated by primary percutaneous coronary interventions (PCIs) is predictive of infarct size and left ventricular ejection fraction (LVEF). However, the comparative value of C-reactive protein (CRP) and troponin I for infarct size evaluat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2006.07.016
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Dobutamine and exercise echocardiography are accepted as tests of comparable efficacy for the diagnosis of coronary artery disease. Although dobutamine has been classified as "exercise simulating," the mechanisms of ischemia with dobutamine and exercise have not been well studied. This study sought to compar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70183-8
更新日期:1998-07-01 00:00:00
abstract::Polymorphic ventricular arrhythmias (PVAs) initiated by programmed electrical stimulation may be a nonspecific response or evidence of ventricular electrical instability. To determine if PVAs initiated in patients with spontaneous sustained ventricular tachycardia or fibrillation differ from those which are clearly a ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90008-6
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:The pectoral approach to implantation of cardioverter defibrillators (ICDs) has become a standard in defibrillator therapy because of reduced generator size, weight, and volume. But the size of these devices is still comparable to the size of the early conventional antibradycardia pacemakers that were associ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70270-4
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:The use of vascular closure devices (VCDs) for the reduction of access site complications following percutaneous coronary intervention (PCI) remains controversial. Patients undergoing primary PCI for acute ST-segment elevation myocardial infarction (STEMI) are at high risk of femoral artery complications. A ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.03.009
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Despite a survival benefit and guideline recommendation for beta-blockers in left ventricular systolic dysfunction, beta-blockers are underused in clinical practice. METHODS:Medical practices with > or = 15 patients with heart failure (HF) in the Duke Databank for Cardiovascular Disease (DDCD) were identifi...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2005.06.038
更新日期:2006-05-01 00:00:00
abstract::The effect of participation in cardiac rehabilitation on medical costs was determined by measuring hospitalization charges for cardiac admissions over a 3-year period in 580 post-coronary event patients (58% after coronary bypass surgery, 42% after myocardial infarction), of whom 230 entered a cardiac rehabilitation p...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90696-s
更新日期:1992-04-01 00:00:00
abstract::This study correlates the anatomic pathologic coronary anatomy found by arteriography in each of three groups of symptomatic patients, all with coronary artery disease, divided according to the magnitude of ST-segment depression after an adequate submaximal treadmill exercise test. Group I consists of 45 patients with...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90080-0
更新日期:1975-03-01 00:00:00