Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of the ARISTOTLE trial

Lancet Neurology
J Donald EastonARISTOTLE Committees and Investigators

Abstract

In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy and safety of apixaban compared with warfarin in prespecified subgroups of patients with and without previous stroke or TIA. Between Dec 19, 2006, and April 2, 2010, patients were enrolled in the ARISTOTLE trial at 1034 clinical sites in 39 countries. 18,201 patients with AF or atrial flutter were randomly assigned to receive apixaban 5 mg twice daily or warfarin (target international normalised ratio 2·0-3·0). The median duration of follow-up was 1·8 years (IQR 1·4-2·3). The primary efficacy outcome was stroke or systemic embolism, analysed by intention to treat. The primary safety outcome was major bleeding in the on-treatment population. All participants, investigators, and sponsors were masked to treatment assignments. In this subgroup analysis, we estimated event rates and used Cox models to compare outcomes in patients with and without previous stroke or TIA. The ARISTOTLE trial is registered with ClinicalTrials.gov, number NTC004...Continue Reading

References

Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Aug 1, 1989·Stroke; a Journal of Cerebral Circulation·R G Hart, C Putnam
Aug 1, 1989·Stroke; a Journal of Cerebral Circulation·R L SaccoT R Price
Oct 1, 1984·Neurology·R E KelleyA G Kovacs
Jul 1, 1983·Stroke; a Journal of Cerebral Circulation·J I Sage, R L Van Uitert
Sep 1, 1983·Stroke; a Journal of Cerebral Circulation·R G HartD Hart
Jul 1, 1984·Archives of Neurology·D G ShermanJ D Easton
Dec 3, 1999·BMJ : British Medical Journal·D G Altman, P K Andersen
Nov 2, 2002·Stroke; a Journal of Cerebral Circulation·Robert G HartLesly A Pearce
Apr 22, 2005·Journal of Thrombosis and Haemostasis : JTH·S SchulmanUNKNOWN Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on T
Oct 4, 2008·Drug Metabolism and Disposition : the Biological Fate of Chemicals·Nirmala RaghavanDonglu Zhang
Jan 1, 2010·The New England Journal of Medicine·Donald Stuart Houston, Ryan Zarychanski
Nov 5, 2010·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN Randomized Evaluation of Long-Term Anticoagulation Therapy Investigators
Feb 12, 2011·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN AVERROES Steering Committee and Investigators
Aug 30, 2011·The New England Journal of Medicine·Christopher B GrangerUNKNOWN ARISTOTLE Committees and Investigators

❮ Previous
Next ❯

Citations

Jul 13, 2013·Journal of Thrombosis and Thrombolysis·Sean D PokorneyRichard C Becker
Dec 19, 2012·Internal and Emergency Medicine·Sergio Coccheri, Donatella Orlando
Jun 14, 2013·Current Atherosclerosis Reports·Graeme J Hankey, John W Eikelboom
Aug 21, 2013·Best Practice & Research. Clinical Haematology·H C DienerR G Hart
Aug 21, 2013·Best Practice & Research. Clinical Haematology·Tatjana S Potpara, Gregory Y H Lip
Dec 24, 2013·Lancet Neurology·Graeme J Hankey
Dec 11, 2013·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Vito Toso
Jul 12, 2014·Postgraduate Medical Journal·Richard P W Cowell
Dec 3, 2014·Cardiology Clinics·Mikhail S Dzeshka, Gregory Y H Lip
Feb 2, 2013·Tijdschrift voor gerontologie en geriatrie·T A Simmers
Aug 19, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Shinya GotoShu Takagi
May 11, 2012·Lancet Neurology·Robert G Hart, John W Eikelboom
Mar 13, 2016·Heart Failure Clinics·Mikhail S Dzeshka, Gregory Y H Lip
Jan 13, 2015·International Journal of Stroke : Official Journal of the International Stroke Society·Kazunori ToyodaUNKNOWN SAMURAI Study Investigators
Mar 31, 2016·Current Neurology and Neuroscience Reports·Sofya KuznetsovSri K Madan Mohan
Apr 4, 2015·Journal of the American College of Cardiology·Richard J KovacsKim A Williams
Jul 15, 2015·Progress in Cardiovascular Diseases·Tatjana S Potpara, Gregory Y H Lip
Jul 26, 2014·Journal of the American College of Cardiology·Stephan WindeckerBernhard Meier
Jun 28, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·A John CammUNKNOWN Writing Committee of the Action for Stroke Prevention alliance
Apr 26, 2015·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Yumiko NakanoKoji Abe
Dec 3, 2014·Trends in Cardiovascular Medicine·Mikhail S Dzeshka, Gregory Y H Lip
Dec 3, 2014·Revista Española De Cardiología·Antoni Martínez-Rubio, Roger Martínez-Torrecilla
Jun 1, 2014·La Presse médicale·Emmanuel Touzé, Doina Ciocanu

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.