Abstract:
AIMS:Non-vitamin K antagonist oral anticoagulants (NOACs) require dose reductions according to patient or clinical factors for patients with atrial fibrillation (AF). In this meta-analysis, we aimed to assess outcomes with reduced-dose NOACs when given as pre-specified in pivotal trials. METHODS AND RESULTS:Aggregated data abstracted from Phase III trials comparing NOACs with warfarin in patients with AF were assessed by treatment using risk ratios (RRs) and 95% confidence intervals (CIs) stratified by patient eligibility for NOAC dose reduction. Irrespective of treatments, annualized rates of stroke or systemic embolism and major bleeding were higher in patients eligible for reduced-dose NOACs than in those eligible for full-dose NOACs (2.70% vs. 1.60% and 4.35% vs. 2.87%, respectively). Effects of reduced-dose NOACs compared with warfarin in patients eligible for reduced-dose NOACs on stroke or systemic embolism [RR 0.84 (95% CI 0.69-1.03)] and on major bleeding [RR 0.70 (95% CI 0.50-0.97)] were consistent with those of full-dose NOACs relative to warfarin in those eligible for full-dose NOACs [RR 0.86 (95% CI 0.77-0.96) for stroke or systemic embolism and RR 0.87 (95% CI 0.70-1.08) for major bleeding; interaction P, 0.89 and 0.26, respectively]. In addition, NOACs were associated with reduced risks of haemorrhagic stroke, intracranial haemorrhage, fatal bleeding, and death regardless of patient eligibility for NOAC dose reduction (interaction P > 0.05 for each). CONCLUSIONS:Patients eligible for reduced-dose NOACs were at elevated risk of thromboembolic and haemorrhagic complications when treated with anticoagulants. NOACs, when appropriately dose-adjusted, had an improved benefit-harm profile compared with warfarin. Our findings highlight the importance of prescribing reduced-dose NOACs for indicated patient populations.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Wang KL,Lopes RD,Patel MR,Büller HR,Tan DS,Chiang CE,Giugliano RPdoi
10.1093/eurheartj/ehy802subject
Has Abstractpub_date
2019-05-14 00:00:00pages
1492-1500issue
19eissn
0195-668Xissn
1522-9645pii
5255630journal_volume
40pub_type
杂志文章,meta分析abstract:BACKGROUND:Recent studies have shown that left ventricular geometric adaptation to hypertension is complex. The spectrum of geometric adaptations in a general population and its relationship to systolic and diastolic function has, however, not been investigated. OBJECTIVES AND METHODS:This echocardiographic and Dopple...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014795
更新日期:1996-12-01 00:00:00
abstract:AIMS:Current data concerning the influence of X-ray contrast media on the incidence of thrombotic complications in interventional cardiology are controversial. The effect of ionic contrast media on acute (< or =72 h) and subacute (< or =30 days) stent thrombosis has not been investigated. METHODS:Three thousand, nine ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/euhj.2000.2319
更新日期:2001-03-01 00:00:00
abstract::Between January 1983 and December 1990, 20 patients aged 80 years or older underwent valvular surgery. The patients' ages varied from 80 to 87 years (mean, 82 +/- 1.5 years). The indication for operation was aortic stenosis in 19 patients, and mitral insufficiency after previous mitral valve replacement with a biopros...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060205
更新日期:1992-04-01 00:00:00
abstract:AIMS:Intravascular ultrasound (IVUS) assesses arterial remodelling by comparing the lesion external elastic membrane (EEM) with the reference segments; however, reference segments are rarely disease-free. The aim was to assess lesion and reference segment remodelling and plaque burden in patients with type-2 diabetes m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm175
更新日期:2007-07-01 00:00:00
abstract:AIMS:To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. METHODS AND RESULTS:We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm338
更新日期:2008-05-01 00:00:00
abstract:AIMS:The aim of this study was to evaluate (1) homocysteinemia and the prevalence of the C677T MTHFR polymorphism in Marfan patients and (2) whether the severity of cardiovascular manifestations is associated with homocysteinemia and/or C677T polymorphism. METHODS AND RESULTS:We studied 107 patients subdivided into th...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2003.08.020
更新日期:2003-11-01 00:00:00
abstract:AIMS:There have been substantial declines in cerebrovascular disease mortality across much of Europe, mirroring trends in deaths from cardiovascular disease as a whole. No study has investigated trends in cerebrovascular disease, and its subtypes within all European countries. This study aimed to examine sex-specific t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehy378
更新日期:2019-03-01 00:00:00
abstract::On the occasion of a routine medical check-up 256 out of 1100 individuals with an accumulation of coronary risk factors were screened for silent myocardial ischaemia by exercise testing and Holter monitoring. Of these individuals 5.5% had a pathological exercise test, 7.4% had ischaemia-like events on the Holter ECG, ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_n.65
更新日期:1988-12-01 00:00:00
abstract::The implementation of molecular biological approaches has led to the discovery of single genetic variations that contribute to the development of cardiac failure. In the present review, the characteristics that are invariably associated with the development of failure in experimental animals and clinical studies are d...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0195-668x(02)00829-1
更新日期:2003-05-01 00:00:00
abstract:AIMS:Here, we aimed to determine the therapeutic effect of longevity-associated variant (LAV)-BPIFB4 gene therapy on atherosclerosis. METHODS AND RESULTS:ApoE knockout mice (ApoE-/-) fed a high-fat diet were randomly allocated to receive LAV-BPIFB4, wild-type (WT)-BPIFB4, or empty vector via adeno-associated viral vec...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz459
更新日期:2020-07-07 00:00:00
abstract::Increased arteriolar tone is the pathophysiological hallmark of essential hypertension and is determined by the intracellular free calcium concentration in the vascular smooth muscle cell. Calcium influx is an important determinant of vasoconstriction and excess calcium influx-dependent vasoconstriction has been shown...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/8.suppl_k.49
更新日期:1987-11-01 00:00:00
abstract:AIMS:N-terminal pro-brain natriuretic peptide (NT-proBNP) levels predict outcomes in ST-elevation myocardial infarction patients treated with fibrinolysis or primary percutaneous coronary intervention (PCI). However, its role in facilitated PCI has not yet been assessed; it may be a tool to evaluate the lower event rat...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehp246
更新日期:2009-09-01 00:00:00
abstract:AIM:To describe the relative impact on survival of the delay from estimated time of collapse to call for an ambulance among patients who suffer from a bystander witnessed out of hospital cardiac arrest of a cardiac aetiology. METHODS:A majority of all ambulance organizations in Sweden (covering 85% of Sweden inhabitan...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/s0195-668x(03)00475-5
更新日期:2003-10-01 00:00:00
abstract:AIMS:Growing data suggest that antibiotic exposure is associated with a long-lasting alteration in gut microbiota, and may be related to subsequent cardiovascular disease (CVD). We investigated associations of life-stage and duration of antibiotic exposure during adulthood with subsequent CVD events. METHODS AND RESUL...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehz231
更新日期:2019-12-14 00:00:00
abstract:AIMS:Thrombin plays a key role in the clinical syndrome of unstable angina. We investigated the safety and efficacy of five dose levels of efegatran sulphate, a direct thrombin inhibitor, compared to heparin in patients with unstable angina. METHODS:Four hundred and thirty-two patients with unstable angina were enroll...
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:10.1053/euhj.1999.1477
更新日期:1999-08-01 00:00:00
abstract::Earlier studies have shown that return to work following PTCA is frequent; however PTCA is now performed in patients with more extensive coronary artery disease. The present study was designed to compare the vocational outcome of patients who underwent PTCA in 1980-1982 with that of patients who underwent the procedur...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_g.54
更新日期:1989-12-01 00:00:00
abstract::In the Danish Verapamil Infarction Trial II (DAVIT II) intervention with verapamil significantly decreased the first major event rate (i.e. reinfarction or death) in patients recovering from acute myocardial infarction. As calcium channel antagonists might have a detrimental effect in patients with heart failure, the ...
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:10.1093/eurheartj/14.4.540
更新日期:1993-04-01 00:00:00
abstract::The aim of our study was to examine if echocardiography can reproducibly be used in a multicentre study to select high risk patients with reduced left ventricular function early after an acute myocardial infarction (MI). In the TRAndolapril Cardiac Evaluation Study (TRACE) patients with reduced left ventricular systol...
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.a060443
更新日期:1994-12-01 00:00:00
abstract:AIMS:The coefficient of variation is a popular measure for describing the amount of repeat variability present in ECG measurements from recording to recording. However, it can be misleading. The aim of the present study was to assess repeat variation (reclassification) in computer measured ECG criteria, i.e. positive t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1997.0741
更新日期:1998-02-01 00:00:00
abstract::Non-thrombotic PE does not represent a distinct clinical syndrome. It may be due to a variety of embolic materials and result in a wide spectrum of clinical presentations, making the diagnosis difficult. With the exception of severe air and fat embolism, the haemodynamic consequences of non-thrombotic emboli are usual...
journal_title:European heart journal
pub_type: 杂志文章,实务指引
doi:10.1093/eurheartj/ehn310
更新日期:2008-09-01 00:00:00
abstract::Ten patients with chronic intermittent claudication were included in a double-blind, randomized cross-over study of placebo, propranolol 80 mg b.i.d. and metoprolol 100 mg b.i.d., each given for two months. At the end of each treatment period, the patients were tested on a treadmill and the time to first claudication ...
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.a061440
更新日期:1983-03-01 00:00:00
abstract::Plasma neuropeptide Y-like immunoreactivity (NPY-LI) is elevated in patients with acute myocardial ischaemia and congestive heart failure (CHF) owing to increased activity of the sympathetic nervous system. The prognostic value of plasma NPY-LI with regard to mortality was studied in 324 random patients admitted to a ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060526
更新日期:1994-04-01 00:00:00
abstract:AIMS:The cardiac extracellular matrix is highly involved in regulating inflammation, remodelling, and function of the heart. Whether matrix alterations relate to the degree of inflammation, fibrosis, and overall rejection in the human transplanted heart remained, until now, unknown. METHODS AND RESULTS:Expression of m...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehs375
更新日期:2013-07-01 00:00:00
abstract::Myocardial relaxation is an energy-dependent process. Indeed, adenosine triphosphate (ATP) is required to pump free myoplasmic calcium back into the sarcoplasmic reticulum. It is also necessary to extrude the calcium ions which enter the cell during the plateau phase of the action potential. The calcium-sodium exchang...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/11.suppl_c.30
更新日期:1990-05-01 00:00:00
abstract::Advances in molecular genetics present new opportunities and challenges for cardiologists who manage patients and families with cardiomyopathies. The aims of this position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases are to review the general issues related to ge...
journal_title:European heart journal
pub_type: 共识发展会议,杂志文章
doi:10.1093/eurheartj/ehq271
更新日期:2010-11-01 00:00:00
abstract::A time-domain signal-averaged ECG was performed in 52 patients with arrhythmogenic right ventricular dysplasia (ARVD) proven by angiography, in 45 control subjects with normal hearts, and in 132 patients with various types of ventricular arrhythmias and no evidence of cardiac disease during routine cardiac examination...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.suppl_e.80
更新日期:1993-09-01 00:00:00
abstract::The diagnosis of prosthetic valve thrombosis (PVT) may be difficult in cases without valve obstruction. The aim of this study was to evaluate the diagnostic accuracy of 111indium-labelled autologous platelet imaging in the detection of PVT. We studied 41 patients with 45 prostheses, mechanical (37) or biological (8), ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059721
更新日期:1990-05-01 00:00:00
abstract::Twenty-one consecutive patients with testicular cancer treated with bleomycin, vinblastine, and cisplatin (PVB) were evaluated for acute vascular ischaemic events during chemotherapy. Angina pectoris occurred in 8/21 (38%) patients, a median 5.6 weeks after initiation of chemotherapy and persisted for 2-7 days. Raynau...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062542
更新日期:1988-05-01 00:00:00
abstract:AIMS:Morphological characteristics of non-significant coronary plaques (NSCPs) that develop rapid progression have not been fully elucidated. The aim of this study was to clarify the morphological characteristics of NSCPs in patients with coronary artery disease (CAD) using intravascular optical coherence tomography (O...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr284
更新日期:2012-01-01 00:00:00
abstract::Although the main cardiac complication in patients with rheumatoid arthritis is subclinical pericarditis, mononuclear cell infiltrations into myocardium may cause cardiac arrhythmias and conduction defects. In order to examine these problems we evaluated 70 patients (53 women and 17 men) aged 18-83 years (average 56.7...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061005
更新日期:1995-06-01 00:00:00