High incidence of asymptomatic AF
This presentation is the property of its rightful owner.
Sponsored Links
1 / 6

High incidence of asymptomatic AF PowerPoint PPT Presentation


  • 59 Views
  • Uploaded on
  • Presentation posted in: General

High incidence of asymptomatic AF. 110 patients with history of paroxysmal/persistent AF but in sinus rhythm at baseline. All patients received antiarrhythmic drug therapy. AF detected by implanted monitoring pacemaker. 100. 80. P < 0.0001. 60. Patients. 40.

Download Presentation

High incidence of asymptomatic AF

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


High incidence of asymptomatic af

High incidence of asymptomatic AF

110 patients with history of paroxysmal/persistent AF but in sinusrhythm at baseline. All patients received antiarrhythmic drug therapy

AF detected by implanted monitoring pacemaker

100

80

P < 0.0001

60

Patients

40

AF detected by ECG at follow-up (FU) visit

20

0

Baseline

FU1

FU2

FU3

FU4

FU5

FU6

FU7

FU8

FU9

FU10

n

110

110

110

110

85

73

60

48

39

25

15

Israel CW et al. J Am Coll Cardiol. 2004:43:47-52.


High incidence of asymptomatic af

High incidence of asymptomatic AF: Clinical implications

“The implications for treatment are clear, namely that apparent freedom from AF

does not, per se, obviate the need for oral anticoagulation.”

Kaufman ES, Waldo AL. J Am Coll Cardiol. 2004;43:53-4.


High incidence of asymptomatic af

INR

Odds ratio* (3-mos mortality)

<2.0

2.0–3.0

>3.0

1.9

2.7

5.5

Warfarin increases hemorrhagic stroke mortality

Lobar ICH

Deep hemispheric ICH

60

60

57.6

40

40

44.2

%Patients

28.6

20

20

22.5

0

0

Nowarfarin

Warfarin

Nowarfarin

Warfarin

ICH = intracerebral hemorrhage

*Relative to no warfarin; P < 0.01 for trend across INR categories

Rosand J et al. Arch Intern Med. 2004;164:880-4.


High incidence of asymptomatic af

Trials of emerging antithrombotic therapiesfor stroke prevention in AF

TrialTreatmentStatus

AMADEUSIdraparinux* vs warfarin Ongoing

ACTIVEClopidogrel + aspirinOngoingvs warfarin (ACTIVE W) or vs aspirin (ACTIVE A)

SPORTIF III/VXimelagatran vs warfarin Completed

Hankey GJ et al. Stroke. 2004;35:389-91.

*Administered sc 1/week


High incidence of asymptomatic af

SPORTIF III and V pooled results:

Primary outcome

Ximelagatran better

Warfarin better

–0.66

P = 0.10

SPORTIF III

+0.45

P = 0.13

SPORTIF V

–0.03

Pooled

P = 0.94

Noninferiority

-4

-3

-2

-1

0

1

2

3

4

Difference in absolute event rates

(ximelagatran – warfarin)

Stroke Prevention using an ORal ThrombinInhibitor in patients with atrial Fibrillation

Halperin JL. AHA Scientific Sessions 2003; Orlando, Fla.


High incidence of asymptomatic af

SPORTIF III and V pooled results:

Net clinical benefit

On-treatment analysis

Warfarin

Ximelagatran

Primary events + major bleeding + death

10

RRR = 26%P = 0.019

RRR = 7%P = 0.527

RRR = 16%P = 0.038

8

Eventrate(%/year)

6

6.1

6.3

6.2

5.8

5.2

4

4.6

2

0

SPORTIF III

SPORTIF V

Pooled

RRR = relative risk reduction

Stroke Prevention using an ORal ThrombinInhibitor in patients with atrial Fibrillation

Halperin JL. AHA Scientific Sessions 2003; Orlando, Fla.


  • Login