insights of the re ly cha 2 ds 2 vasc subgroup analysis hisao ogawa kumamoto university japan n.
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Insights of the RE-LY CHA 2 DS 2 -VASc subgroup analysis Hisao Ogawa Kumamoto University, Japan. CHA 2 DS 2 -VASc. maximum score is 9 since age may contrubute 0, 1, or 2 points. Lip GY, et al., Chest 137, 263-272, 2010. CHA 2 DS 2 -VASc – overall event rates. 6. 5. 4. 3. 2. 1. 0.

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slide2

CHA2DS2-VASc

maximum score is 9 since age may contrubute 0, 1, or 2 points

Lip GY, et al., Chest 137, 263-272, 2010

cha 2 ds 2 vasc overall event rates
CHA2DS2-VASc – overall event rates

6

5

4

3

2

1

0

0-1

634

2

3408

3

5365

4

4378

5

2566

6

1185

7

451

8-9

125

CHA2DS2-VASc

No of patients

Stroke and systemic embolism

%/year

cha 2 ds 2 vasc overall event rates1
CHA2DS2-VASc – overall event rates

8

7

6

5

4

3

2

1

0

0-1

634

2

3408

3

5365

4

4378

5

2566

6

1185

7

451

8-9

125

CHA2DS2-VASc

No of patients

Major (including intracranial) bleeding

%/year

Intracranial

Major

slide5

The Net Clinical Benefit of warfarin by CHADS2score

CHADS2score

2.22

4-6

0.58

3.75

2.07

3

1.21

2.79

0.97

2

0.43

1.41

0.19

1

-0.27

0.45

-0.11

0

-0.44

-0.20

-1

-0.5

0

0.5

1

1.5

2

2.5

3

3.5

Worse with Warfarin

Better with Warfarin

Singer DE, et al. : Ann Intern Med. 151, 297-305, 2009

slide6

Stroke and systemic embolism (SE)

D110 BID vs. warfarin

D150 BID vs. warfarin

Annual rate, %

CHA2DS2-VASc

D110

D150

Warfarin

0.8

0.9

0.5

≤2

3

1.4

1.3

0.8

2.0

4

1.6

1.0

2.8

5-9

2.4

2.1

p(inter)=0.60

p(inter)=0.81

0.50

1.00

1.50

0.50

1.00

1.50

Dabigatran

better

Warfarin

better

Dabigatran

better

Warfarin

better

slide7

Intracranial bleeding

D110 BID vs. warfarin

D150 BID vs. warfarin

Annual rate, %

CHA2DS2-VASc

D110

D150

Warfarin

≤2

0.15

0.11

0.38

3

0.16

0.32

0.76

4

0.29

0.21

1.04

5-9

0.32

0.63

0.84

p(inter)=0.09

p(inter)=0.77

0.50

1.00

1.50

0.50

1.00

1.50

Warfarin

better

Dabigatran

better

Warfarin

better

Dabigatran better

conclusion
Conclusion
  • Increasing CHA2DS2-VASc scores are associated with

raised risks for stroke and bleeding,

  • Irrespective of CHA2DS2-VASc scores dabigatran 150 mg

was superior and dabigatran 110 mg non-inferior to warfarin

for stroke prevention

  • Both dabigatran doses reduce intracranial bleeding irrespective

of CHA2DS2-VASc scores

Dabigatran has a favorable benefit risk profile

compared to warfarin in patients with low to

high CHA2DS2-VASc scores

ad