Oral Anticoagulants in the Oldest Old with Recent Stroke and Atrial Fibrillation.
Journal
Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
03
11
2021
received:
09
07
2021
accepted:
04
11
2021
pubmed:
9
11
2021
medline:
15
1
2022
entrez:
8
11
2021
Statut:
ppublish
Résumé
To investigate the safety and effectiveness of direct oral anticoagulants (DOAC) versus vitamin K antagonists (VKA) after recent stroke in patients with atrial fibrillation (AF) aged ≥85 years. Individual patient data analysis from seven prospective stroke cohorts. We compared DOAC versus VKA treatment among patients with AF and recent stroke (<3 months) aged ≥85 versus <85 years. Primary outcome was the composite of recurrent stroke, intracranial hemorrhage (ICH) and all-cause death. We used simple, adjusted, and weighted Cox regression to account for confounders. We calculated the net benefit of DOAC versus VKA by balancing stroke reduction against the weighted ICH risk. In total, 5,984 of 6,267 (95.5%) patients were eligible for analysis. Of those, 1,380 (23%) were aged ≥85 years and 3,688 (62%) received a DOAC. During 6,874 patient-years follow-up, the impact of anticoagulant type (DOAC versus VKA) on the hazard for the composite outcome did not differ between patients aged ≥85 (HR The favorable profile of DOAC over VKA in patients with AF and recent stroke was maintained in the oldest old. ANN NEUROL 2022;91:78-88.
Identifiants
pubmed: 34747514
doi: 10.1002/ana.26267
pmc: PMC9300111
doi:
Substances chimiques
Factor Xa Inhibitors
0
Vitamin K
12001-79-5
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
78-88Subventions
Organisme : Italian Ministery of Heatlh Ricerca Corrente IRCCS MultiMedica
Organisme : Stroke Fund and Scientific Fund of the University Hospital Basel, Switzerland
Organisme : Medical Research Council
ID : MR/N003403/1
Pays : United Kingdom
Organisme : National Cerebral and Cardiovascular Center
ID : Intramural Research Fund (H28-4-1)
Organisme : Daiichi Sankyo AG (Switzerland)
Organisme : Ministry of Health, Labour and Welfare
ID : Grant-in-Aid (H23-Junkanki-Ippan-010)
Organisme : British Stroke Association
Organisme : Science Fund Rehabilitation of the University Department of Geriatric Medicine Felix Platter Basel, Switzerland
Organisme : National Cerebral and Cardiovascular Center
ID : Intramural Research Fund (H23-4-3)
Organisme : Swiss Heart Foundation
Organisme : British Heart Foundation
ID : CS/17/6/33361
Pays : United Kingdom
Organisme : Bayer AG (Switzerland)
Investigateurs
Stefan T Engelter
(ST)
Philippe A Lyrer
(PA)
Leo H Bonati
(LH)
David J Seiffge
(DJ)
Christopher Traenka
(C)
Alexandros A Polymeris
(AA)
Annaelle Zietz
(A)
Nils Peters
(N)
Gian Marco De Marchis
(GM)
Sebastian Thilemann
(S)
Nikolaos S Avramiotis
(NS)
Henrik Gensicke
(H)
Lisa Hert
(L)
Benjamin Wagner
(B)
Fabian Schaub
(F)
Louisa Meya
(L)
Joachim Fladt
(J)
Tolga Dittrich
(T)
Urs Fisch
(U)
Kosmas Macha
(K)
David Haupenthal
(D)
Luise Gassmann
(L)
Ruihao Wang
(R)
Svenja Stoll
(S)
Stefan Schwab
(S)
Bastian Volbers
(B)
Gabriela Siedler
(G)
Bernd Kallmünzer
(B)
Manuel Cappellari
(M)
Bruno Bonetti
(B)
Paolo Bovi
(P)
Giampaolo Tomelleri
(G)
Nicola Micheletti
(N)
Cecilia Zivelonghi
(C)
Andrea Emiliani
(A)
Adrian Parry-Jones
(A)
Chris Patterson
(C)
Christopher Price
(C)
Abduelbaset Elmarimi
(A)
Anthea Parry
(A)
Arumug Nallasivam
(A)
Azlisham Mohd Nor
(AM)
Bernard Esis
(B)
David Bruce
(D)
Biju Bhaskaran
(B)
Christine Roffe
(C)
Claire Cullen
(C)
Clare Holmes
(C)
David Cohen
(D)
David Hargroves
(D)
David Mangion
(D)
Dinesh Chadha
(D)
Djamil Vahidassr
(D)
Dulka Manawadu
(D)
Elio Giallombardo
(E)
Elizabeth Warburton
(E)
Enrico Flossman
(E)
Gunaratam Gunathilagan
(G)
Harald Proschel
(H)
Hedley Emsley
(H)
Ijaz Anwar
(I)
Ilse Burger
(I)
James Okwera
(J)
Janet Putterill
(J)
Janice O'Connell
(J)
John Bamford
(J)
John Corrigan
(J)
Jon Scott
(J)
Jonathan Birns
(J)
Karen Kee
(K)
Kari Saastamoinen
(K)
Kath Pasco
(K)
Krishna Dani
(K)
Lakshmanan Sekaran
(L)
Lillian Choy
(L)
Liz Iveson
(L)
Maam Mamun
(M)
Mahmud Sajid
(M)
Martin Cooper
(M)
Matthew Burn
(M)
Matthew Smith
(M)
Michael Power
(M)
Michelle Davis
(M)
Nigel Smyth
(N)
Roland Veltkamp
(R)
Pankaj Sharma
(P)
Paul Guyler
(P)
Paul O'Mahony
(P)
Peter Wilkinson
(P)
Prabel Datta
(P)
Prasanna Aghoram
(P)
Rachel Marsh
(R)
Robert Luder
(R)
Sanjeevikumar Meenakishundaram
(S)
Santhosh Subramonian
(S)
Simon Leach
(S)
Sissi Ispoglou
(S)
Sreeman Andole
(S)
Timothy England
(T)
Aravindakshan Manoj
(A)
Frances Harrington
(F)
Habib Rehman
(H)
Jane Sword
(J)
Julie Staals
(J)
Karim Mahawish
(K)
Kirsty Harkness
(K)
Louise Shaw
(L)
Michael McCormich
(M)
Nikola Sprigg
(N)
Syed Mansoor
(S)
Vinodh Krishnamurthy
(V)
Michela Giustozzi
(M)
Monica Acciarresi
(M)
Giancarlo Agnelli
(G)
Valeria Caso
(V)
Cecilia Becattini
(C)
Andrea Alberti
(A)
Michele Venti
(M)
Cataldo D'Amore
(C)
Maria Giulia Mosconi
(MG)
Ludovica Anna Cimini
(LA)
Maurizio Paciaroni
(M)
Fabio Bandini
(F)
Georgios Tsivgoulis
(G)
Chrissoula Liantinioti
(C)
Maria Chondrogianni
(M)
Shadi Yaghi
(S)
Karen L Furie
(KL)
Prasanna Tadi
(P)
Marialuisa Zedde
(M)
Azmil H Abdul-Rahim
(AH)
Kennedy R Lees
(KR)
Paolo Bovi
(P)
Monica Carletti
(M)
Alberto Rigatelli
(A)
Manuel Cappellari
(M)
Jukka Putaala
(J)
Liisa Tomppo
(L)
Turgut Tatlisumak
(T)
Simona Marcheselli
(S)
Alessandro Pezzini
(A)
Loris Poli
(L)
Alessandro Padovani
(A)
Vieri Vannucchi
(V)
Luca Masotti
(L)
Sung-Il Sohn
(SI)
Gianni Lorenzini
(G)
Rossana Tassi
(R)
Francesca Guideri
(F)
Maurizio Acampa
(M)
Giuseppe Martini
(G)
George Ntaios
(G)
George Athanasakis
(G)
Konstantinos Makaritsis
(K)
Efstathia Karagkiozi
(E)
Konstantinos Vadikolias
(K)
Nicola Mumoli
(N)
Franco Galati
(F)
Simona Sacco
(S)
Cindy Tiseo
(C)
Francesco Corea
(F)
Walter Ageno
(W)
Marta Bellesini
(M)
Giovanna Colombo
(G)
Giorgio Silvestrelli
(G)
Alfonso Ciccone
(A)
Alessia Lanari
(A)
Umberto Scoditti
(U)
Licia Denti
(L)
Michelangelo Mancuso
(M)
Miriam Maccarrone
(M)
Leonardo Ulivi
(L)
Giovanni Orlandi
(G)
Nicola Giannini
(N)
Tiziana Tassinari
(T)
Maria Luisa De Lodovici
(ML)
Christina Rueckert
(C)
Antonio Baldi
(A)
Danilo Toni
(D)
Federica Letteri
(F)
Alessio Pieroni
(A)
Martina Giuntini
(M)
Enrico Maria Lotti
(EM)
Yuriy Flomin
(Y)
Odysseas Kargiotis
(O)
Theodore Karapanayiotides
(T)
Serena Monaco
(S)
Mario Maimone Baronello
(MM)
Laszló Csiba
(L)
Lilla Szabó
(L)
Alberto Chiti
(A)
Elisa Giorli
(E)
Massimo Del Sette
(M)
Davide Imberti
(D)
Dorjan Zabzuni
(D)
Boris Doronin
(B)
Vera Volodina
(V)
Patrik Michel
(P)
Peter Vanacker
(P)
Kristian Barlinn
(K)
Lars-Peder Pallesen
(LP)
Jessica Barlinn
(J)
Dirk Deleu
(D)
Gayane Melikyan
(G)
Faisal Ibrahim
(F)
Naveed Akhtar
(N)
Vanessa Gourbali
(V)
Kenichi Todo
(K)
Kazumi Kimura
(K)
Kensaku Shibazaki
(K)
Yoshiki Yagita
(Y)
Eisuke Furui
(E)
Ryo Itabashi
(R)
Tadashi Terasaki
(T)
Yoshiaki Shiokawa
(Y)
Teruyuki Hirano
(T)
Rieko Suzuki
(R)
Kenji Kamiyama
(K)
Jyoji Nakagawara
(J)
Shunya Takizawa
(S)
Kazunari Homma
(K)
Satoshi Okuda
(S)
Yasushi Okada
(Y)
Koichiro Maeda
(K)
Tomoaki Kameda
(T)
Kazuomi Kario
(K)
Yoshinari Nagakane
(Y)
Yasuhiro Hasegawa
(Y)
Hisanao Akiyama
(H)
Satoshi Shibuya
(S)
Hiroshi Mochizuki
(H)
Yasuhiro Ito
(Y)
Takahiro Nakashima
(T)
Hideki Matsuoka
(H)
Kazuhiro Takamatsu
(K)
Kazutoshi Nishiyama
(K)
Kanta Tanaka
(K)
Kaoru Endo
(K)
Tetsuya Miyagi
(T)
Masato Osaki
(M)
Junpei Kobayashi
(J)
Takuya Okata
(T)
Eijiro Tanaka
(E)
Yuki Sakamoto
(Y)
Keisuke Tokunaga
(K)
Hotake Takizawa
(H)
Junji Takasugi
(J)
Soichiro Matsubara
(S)
Kyoko Higashida
(K)
Takayuki Matsuki
(T)
Naoto Kinoshita
(N)
Masayuki Shiozawa
(M)
Toshihiro Ide
(T)
Takeshi Yoshimoto
(T)
Daisuke Ando
(D)
Kyohei Fujita
(K)
Masaya Kumamoto
(M)
Teppei Kamimura
(T)
Muneaki Kikuno
(M)
Tadataka Mizoguchi
(T)
Takeo Sato
(T)
Informations de copyright
© 2021 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.
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