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Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial.

Publication ,  Journal Article
Ezekowitz, JA; Lewis, BS; Lopes, RD; Wojdyla, DM; McMurray, JJV; Hanna, M; Atar, D; Cecilia Bahit, M; Keltai, M; Lopez-Sendon, JL; Pais, P ...
Published in: Eur Heart J Cardiovasc Pharmacother
April 2015

AIMS: We compared clinical outcomes in patients with AF with and without diabetes in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial. METHODS AND RESULTS: The main efficacy endpoints were SSE and mortality; safety endpoints were major and major/clinically relevant non-major bleeding. A total of 4547/18 201 (24.9%) patients had diabetes who were younger (69 vs. 70 years), more had coronary artery disease (39 vs. 31%), and higher mean CHADS2 (2.9 vs. 1.9) and HAS-BLED scores (1.9 vs. 1.7) (all P < 0.0001) than patients without diabetes. Patients with diabetes receiving apixaban had lower rates of SSE [hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.53-1.05), all-cause mortality (HR 0.83, 95% CI 0.67-1.02), cardiovascular mortality (HR 0.89, 95% CI 0.66-1.20), intra-cranial haemorrhage (HR 0.49, 95% CI 0.25-0.95), and a similar rate of myocardial infarction (HR 1.02, 95% CI 0.62-1.67) compared with warfarin. For major bleeding, a quantitative interaction was seen (P-interaction = 0.003) with a greater reduction in major bleeding in patients without diabetes even after multivariable adjustment. Other measures of bleeding showed a consistent reduction with apixaban compared with warfarin without a significant interaction based on diabetes status. CONCLUSION: Apixaban has similar benefits on reducing stroke, decreasing mortality, and causing less intra-cranial bleeding than warfarin in patients with and without diabetes.

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Published In

Eur Heart J Cardiovasc Pharmacother

DOI

EISSN

2055-6845

Publication Date

April 2015

Volume

1

Issue

2

Start / End Page

86 / 94

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thromboembolism
  • Survival Rate
  • Pyridones
  • Pyrazoles
  • Middle Aged
  • Male
  • Intracranial Hemorrhages
  • Incidence
  • Humans
 

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Ezekowitz, J. A., Lewis, B. S., Lopes, R. D., Wojdyla, D. M., McMurray, J. J. V., Hanna, M., … Alexander, J. H. (2015). Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother, 1(2), 86–94. https://doi.org/10.1093/ehjcvp/pvu024
Ezekowitz, Justin A., Basil S. Lewis, Renato D. Lopes, Daniel M. Wojdyla, John J. V. McMurray, Michael Hanna, Dan Atar, et al. “Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial.Eur Heart J Cardiovasc Pharmacother 1, no. 2 (April 2015): 86–94. https://doi.org/10.1093/ehjcvp/pvu024.
Ezekowitz JA, Lewis BS, Lopes RD, Wojdyla DM, McMurray JJV, Hanna M, et al. Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother. 2015 Apr;1(2):86–94.
Ezekowitz, Justin A., et al. “Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial.Eur Heart J Cardiovasc Pharmacother, vol. 1, no. 2, Apr. 2015, pp. 86–94. Pubmed, doi:10.1093/ehjcvp/pvu024.
Ezekowitz JA, Lewis BS, Lopes RD, Wojdyla DM, McMurray JJV, Hanna M, Atar D, Cecilia Bahit M, Keltai M, Lopez-Sendon JL, Pais P, Ruzyllo W, Wallentin L, Granger CB, Alexander JH. Clinical outcomes of patients with diabetes and atrial fibrillation treated with apixaban: results from the ARISTOTLE trial. Eur Heart J Cardiovasc Pharmacother. 2015 Apr;1(2):86–94.
Journal cover image

Published In

Eur Heart J Cardiovasc Pharmacother

DOI

EISSN

2055-6845

Publication Date

April 2015

Volume

1

Issue

2

Start / End Page

86 / 94

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thromboembolism
  • Survival Rate
  • Pyridones
  • Pyrazoles
  • Middle Aged
  • Male
  • Intracranial Hemorrhages
  • Incidence
  • Humans