Does warfarin for stroke thromboprophylaxis protect against MI in atrial fibrillation patients?

The American Journal of Medicine
Gregory Y H Lip, Deirdre A Lane

Abstract

The Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) study demonstrated a significant increase in myocardial infarction events with dabigatran compared with warfarin, provoking renewed interest in whether vitamin K antagonists are useful drugs for the prevention of myocardial infarction in high-risk patients with atrial fibrillation. Present analyses examined whether there was an increased risk of myocardial infarction associated with non-warfarin anticoagulants (Stroke Prevention with the ORal direct Thrombin Inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial Fibrillation III and IV, RE-LY, Amadeus) or "anticoagulant equivalents" (Atrial fibrillation Clopidogrel Trial with Irbesartan for the prevention of Vascular Events) in patients with atrial fibrillation who are prescribed anticoagulation for stroke thromboprophylaxis. The overall annual event rate for those receiving warfarin was 0.98% compared with 1.32% for those receiving comparators. Warfarin was associated with a significant reduction in myocardial infarction (relative risk 0.77; 95% confidence interval (CI), 0.63-0.95), an effect largely driven by the RE-LY trial. Sensitivity analyses, excluding RE-LY, revealed a non...Continue Reading

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Citations

Aug 21, 2013·Best Practice & Research. Clinical Haematology·Tatjana S Potpara, Gregory Y H Lip
Aug 28, 2012·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 Document Reviewers
Nov 2, 2011·BMJ : British Medical Journal·Brian F Gage
Oct 22, 2013·Vascular Health and Risk Management·Andreas ClemensJeffrey Friedman
Jan 31, 2014·Vascular Health and Risk Management·Daniele Pontillo, Nicolino Patruno
May 10, 2012·Expert Opinion on Pharmacotherapy·Francisco MarínGregory Y H Lip
Nov 13, 2013·Expert Review of Cardiovascular Therapy·Thure F OvervadGregory Y H Lip
Apr 7, 2015·Expert Review of Cardiovascular Therapy·Andres EnriquezKevin Michael
Mar 7, 2014·Expert Opinion on Drug Safety·Richard BrownPilar Gallego
Oct 25, 2014·Expert Opinion on Drug Safety·Mikhail S Dzeshka, Gregory Yh Lip
Dec 24, 2013·The American Journal of Medicine·Torben Bjerregaard LarsenGregory Y H Lip
Nov 7, 2013·International Journal of Cardiology·Maria Cecilia BahitLars Wallentin
Jan 17, 2012·Clinical Cardiology·Jonas Bjerring OlesenGregory Y H Lip
Dec 15, 2012·The Mount Sinai Journal of Medicine, New York·Jonathan L Halperin, Richert E Goyette
Jan 3, 2013·European Journal of Clinical Investigation·Diana Hernández-RomeroVanessa Roldán
Jun 15, 2011·Journal of Cardiovascular Electrophysiology·Juan F Viles-GonzalezJonathan L Halperin
Apr 6, 2013·International Journal of Clinical Practice·K HuberP Widimský
Apr 9, 2013·Journal of the American College of Cardiology·Torben Bjerregaard LarsenGregory Y H Lip
Dec 11, 2013·International Journal of Cardiology·Christian T RuffUNKNOWN REACH Registry Investigators
May 12, 2012·Journal of the American College of Cardiology·Gregory Y H LipLars Hvilsted Rasmussen
Oct 9, 2012·International Journal of Cardiology·Matthias K FreynhoferKurt Huber
Dec 19, 2014·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Ozcan BasaranMurat Biteker
May 5, 2011·The Annals of Pharmacotherapy·Jessica A BovioJohn G Gums
Jan 1, 2012·Pharmaceuticals·Claudia Stöllberger, Josef Finsterer
Mar 13, 2012·Clinical Medicine Insights. Cardiology·Yousif Ahmad, Gregory Y H Lip
Jul 25, 2018·European Heart Journal. Acute Cardiovascular Care·Thomas A ZelnikerRobert P Giugliano
Oct 29, 2015·Circulation. Cardiovascular Quality and Outcomes·Meytal Avgil TsadokLouise Pilote
Apr 6, 2011·Circulation·Graeme J Hankey, John W Eikelboom
Oct 15, 2011·Stroke; a Journal of Cerebral Circulation·Amitava BanerjeeGregory Y H Lip

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