Abstract:
:Among atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI), rivaroxaban with background antiplatelet therapy significantly reduced the first occurrence of bleeding compared to triple therapy with warfarin. This study hypothesized that total bleeding events, including those beyond the first event, would be reduced with rivaroxaban-based regimens. In the PIONEER AF-PCI trial, 2099 patients in the modified intention-to-treat population were randomized to three groups and followed for 12 months: (1) rivaroxaban 15 mg once daily plus a P2Y12 inhibitor (N = 696); (2) rivaroxaban 2.5 mg twice daily plus dual antiplatelet therapy (DAPT) (N = 706); and (3) dose-adjusted warfarin plus DAPT (N = 697). Descriptive statistics for the number of subjects who experienced one or more bleeding events were calculated. The total number of bleeding events was compared across treatment groups using the Wei, Lin, and Weissfeld method. A total of 514 and 439 events of clinically significant bleeding and bleeding requiring medical attention occurred throughout the study. Compared to triple therapy with warfarin, rivaroxaban-based regimen was associated with a reduction in total events of clinically significant bleeding (Group 1 vs. Group 3: HR 0.64 [95% CI 0.49-0.85], p < 0.001, NNT = 11; Group 2 vs. Group 3: HR 0.62 [95% CI 0.48-0.80], p < 0.001, NNT = 10). Similarly, rivaroxaban reduced the total bleeding events requiring medical attention (Group 1 vs. Group 3: HR 0.66 [95% CI 0.49-0.89], p < 0.001, NNT = 14; Group 2 vs. Group 3: HR 0.64 [95% CI 0.48-0.85], p = 0.002, NNT = 13). Rivaroxaban-based regimen reduced the total bleeding events compared with VKA-based triple therapy in stented AF patients. One clinically significant bleeding event could be prevented with rivaroxaban use for every 10-11 patients treated, and one bleeding requiring medical attention could be prevented with rivaroxaban for every 13-14 patients treated. These data provide evidence that total bleeding events, including those beyond the first event, are reduced with rivaroxaban-based antithrombotic regimens. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov . Unique identifier: NCT01830543 (PIONEER AF-PCI).
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Chi G,Yee MK,Kalayci A,Kerneis M,AlKhalfan F,Mehran R,Bode C,Halperin JL,Verheugt FWA,Wildgoose P,van Eickels M,Lip GYH,Cohen M,Peterson ED,Fox KAA,Gibson CMdoi
10.1007/s11239-018-1703-5subject
Has Abstractpub_date
2018-10-01 00:00:00pages
346-350issue
3eissn
0929-5305issn
1573-742Xpii
10.1007/s11239-018-1703-5journal_volume
46pub_type
杂志文章,随机对照试验abstract::A significant proportion of the outcomes reported in trials assessing venous thromboembolism (VTE) prophylaxis in medical patients are related to asymptomatic events found on routine imaging studies. The implications of these events are controversial. Moreover, such trials did not always reflect the patient mix in tod...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-012-0730-x
更新日期:2012-07-01 00:00:00
abstract::We describe the results of a novel complete care package using point-of-care INR testing and computerized decision support for the management of oral anticoagulation by nurse-led primary care clinics in the United Kingdom. We found such therapy to be as safe and effective as traditional hospital-based care for oral an...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-006-5584-7
更新日期:2006-02-01 00:00:00
abstract::The optimal antithrombotic therapy for patients undergoing TAVI with concomitant indication for oral anticoagulation remains unclear. In this high-risk population group, there is a paucity of data with regards to the use of DOACs. In the present study we compared long-term clinical outcomes of TAVI patients requiring ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01968-w
更新日期:2020-07-01 00:00:00
abstract:INTRODUCTION:While the CURE trial demonstrated the benefits of clopidogrel in acute coronary syndromes, patients receiving glycoprotein IIb/IIIa antagonists were excluded. Given the frequent coadministration of these two medications, we sought to examine their interaction and their combined effect on platelet inhibitio...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-004-0170-3
更新日期:2004-08-01 00:00:00
abstract::Recent gene knockout studies on mice have shown the role of toll-like receptor 9 (TLR9) in resolution of venous thromboembolism (VTE) through sterile inflammation. However, the role of a putative functional TLR9 polymorphism (rs5743836) in risk assessment of VTE recurrence remains unknown. The aim of our study was to ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11239-017-1491-3
更新日期:2017-07-01 00:00:00
abstract::Subtilisin QK, a new fibrinolytic enzyme, could cleave directly cross-linked fibrin in vitro. To verify the thrombolytic function of Subtilisin QK in vivo, the thrombolytic effect of purified Subtilisin QK on tail-thrombus of mouse was investigated. After injected with carrageenan, the tail-thrombus of Subtilisin QK t...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0333-3
更新日期:2009-11-01 00:00:00
abstract::Apixaban is effective and safe for preventing stroke, and its usage has increased exponentially in recent years. However, data concerning the therapeutic range of apixaban is limited. This study determined the trough and peak levels of apixaban-specific anti-factor Xa activity (AFXaA) in acute ischemic stroke patients...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-017-1590-1
更新日期:2018-02-01 00:00:00
abstract::The initial treatment of acute venous thrombosis using low-molecular-weight heparin (LMWH) in the outpatient setting has been shown to be feasible, effective, and safe for selected patients when compared with in-hospital treatment using continuous intravenous heparin. There will always be a significant population of p...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/a:1013232803747
更新日期:1998-01-01 00:00:00
abstract::Factor Xa (FXa) inhibitors are recommended for use in fixed doses without laboratory monitoring. However, prior studies reported the importance of establishing biomarkers representing anticoagulation intensity related to bleeding or thrombotic events. To test the hypothesis that prothrombin activation fragment 1 and 2...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02079-7
更新日期:2020-08-01 00:00:00
abstract::Patients with inflammatory bowel disease (IBD) have a 1.5-3.5-fold higher risk of thromboembolism when compared to the non-IBD population and the risk is much more prominent at the time of a flare. Arterial thromboembolism (ischemic stroke, focal white matter ischemia, cardiac ischemia, peripheral vascular disease and...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-014-1129-7
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Apoptosis causes myocardiocyte loss during and after myocardial infarction. Therapeutic approaches designed to arrest apoptosis would be a significant new development in the recovery of acute myocardial infarction (AMI). In order to examine apoptotic markers in the circulation, serum levels of p53 and cytoch...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0328-0
更新日期:2010-01-01 00:00:00
abstract::Pylephlebitis, or suppurative thrombophlebitis of the portal vein, typically occurs in the context of an intraabdominal infection or abdominal sepsis. Antibiotics are the mainstay of treatment. The role of anticoagulation in the management of pylephlebitis is controversial, and data regarding its impact on outcomes is...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01949-z
更新日期:2020-02-01 00:00:00
abstract::Prasugrel has been shown to be superior to clopidogrel in the setting of ACS patients undergoing coronary angioplasty. However, few data have been reported so far on those patients who switch from clopidogrel to prasugrel after coronary angioplasty. Aim of the current study was to evaluate the safety of prasugrel load...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-013-1039-0
更新日期:2014-10-01 00:00:00
abstract::The aim of this study was to evaluate the association of prothrombotic gene polymorphisms [factor V Leiden (FVL) 1691GA, factor VII (FVII) 10976GA, FVII HVR4, platelet membrane glycoproteins GP1BA 1018CT, GP1BA VNTR, integrin ITGB3 1565TC, integrin ITGA2 807CT and methylenetetrahydrofolate reductase (MTHFR) 677C/T], p...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-012-0734-6
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Antithrombin (AT) drop during cardiac surgery has been described. The causes and the effects of this phenomenon are not clear. The objective of the study is to evaluate the relationship of AT postoperative values on short and mid-term outcome after cardiac surgery. METHODS:Between January and June 2005, 405...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0191-9
更新日期:2009-01-01 00:00:00
abstract::Cancer is associated with an increased risk of venous thromboembolism of four to sixfold. Cancer-related interventions such as chemotherapy, hormonal therapy and indwelling central venous catheters also increase the risk of venous thromboembolism. Low molecular weight heparin for at least 3-6 months is the current sta...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1007/s11239-018-1783-2
更新日期:2019-04-01 00:00:00
abstract::Plasminogen activator inhibitor (PAI-1), a member of the serine protein family, is the most active in vivo inhibitor of fibrinolysis induced by plasminogen, tissue plasminogen activator (tPA), and urokinase type plasminogen activator (uPA). While the association between elevated PAI-1 and thrombogenesis has been well ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
doi:10.1023/a:1008907001042
更新日期:1999-08-01 00:00:00
abstract::Fever is a presenting sign in some patients with acute deep venous thrombosis (DVT), but its influence on outcome has not been thoroughly investigated. RIETE is an ongoing, international, observational registry of consecutive patients with symptomatic, objectively confirmed, acute venous thromboembolism. The aim of th...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11239-011-0604-7
更新日期:2011-10-01 00:00:00
abstract::Background: Thrombolytic therapy has been shown to reduce mortality in select patients with acute myocardial infarction (AMI). The determinants of eligibility for therapy are changing as more information about the safety and efficacy of thrombolytic therapy is obtained. In the United States, there is some concern that...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF01062578
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To report our experience with use of thrombolysis with streptokinase during cardiopulmonary resuscitation of patients with cardiac arrest due to myocardial infarction. DESIGN:A case series. METHODS:Thrombolytic therapy (streptokinase) was administered during cardiopulmonary resuscitation of 4 patients with ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-005-3547-z
更新日期:2005-12-01 00:00:00
abstract::Recurrent stroke is common immediately following a transient ischemic attack (TIA) or ischemic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin may provide greater protection against subsequent stroke than monotherapy. Electronic databases were searched for randomized clinical trials (RCTs) compar...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,meta分析
doi:10.1007/s11239-018-1786-z
更新日期:2019-02-01 00:00:00
abstract::Multiple clinical risk prediction tools for hospital acquired venous thromboembolism (HA-VTE) have been developed. The objectives of this study were to develop and assess the feasibility of data extraction from Electronic Medical Records (EMR) from an enterprise database warehouse (EDW) and to test the validity of a p...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02158-9
更新日期:2020-11-01 00:00:00
abstract::Patients with mechanical heart valves (MHV) undergoing invasive procedures often receive periprocedural bridging with low-molecular-weight heparin (LMWH). The bridging strategies used in real-life and the predictors for bleeding and thrombosis are not well studied. We retrospectively assessed patients with MHV that un...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11239-015-1216-4
更新日期:2015-11-01 00:00:00
abstract::The aim of this study was to assess the association between "aspirin non responsiveness" in patients with coronary artery diseases (CAD) and the risk of major adverse cardiovascular events (MACE). 204 patients with CAD receiving aspirin (250 mg/d) were included. Both Collagen/Epinephrine Closure Time (CEPI-CT) and uri...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0335-1
更新日期:2010-01-01 00:00:00
abstract::There were limited studies comparing the anterior (AC) and posterior (PC) circulation acute ischemic strokes (AIS). Our study aimed to evaluate distinct features of AC and PC strokes regarding clinical, vascular risk, pathogenesis and outcome factors after endovascular procedures. This multicenter prospective study re...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02054-2
更新日期:2020-05-01 00:00:00
abstract::The use of magnesium therapy for acute myocardial infarction remains controversial despite recent clinical trials such as ISIS-4. Magnesium has numerous beneficial effects in the setting of myocardial infarction, including inhibitory effects on platelet aggregation. Clinical trials of magnesium therapy for myocardial ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF01064375
更新日期:1995-01-01 00:00:00
abstract::We assessed the effect of the intercellular mediator of inflammation, platelet activating factor (PAF), on platelet function. The interaction between PAF and the platelet agonists ADP, thrombin and convulxin was analyzed in vitro in whole blood with the use of flow cytometry and was further characterized with the use ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-008-0239-5
更新日期:2009-07-01 00:00:00
abstract::This study investigates the association between the treatment with heparin and mortality in patients admitted with Covid-19. Routinely recorded, clinical data, up to the 24th of April 2020, from the 2075 patients with Covid-19, admitted in 17 hospitals in Spain between the 1st of March and the 20th of April 2020 were ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究
doi:10.1007/s11239-020-02162-z
更新日期:2020-08-01 00:00:00
abstract::The US Surgical Care Improvement Project (SCIP) has approved two performance measures to improve venous thromboembolism (VTE) prevention. SCIP-VTE-2 measures the proportion of surgery patients who received appropriate VTE prophylaxis within 24 h prior to surgery to 24 h after surgery. This study assesses the current r...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-009-0393-4
更新日期:2010-07-01 00:00:00
abstract::Each year venous thromboembolism (VTE) causes up to 60,000 deaths in the UK, many resulting from hospital-acquired thromboses following elective surgery. National Institute for Health and Clinical Excellence (NICE) guidelines state that all elective surgical patients should receive verbal and written information pre-o...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-015-1224-4
更新日期:2016-04-01 00:00:00