P300Impact of gender: rivaroxaban for patients with atrial fibrillation in the XANTUS real-world prospective study
Notice bibliographique
Résumé
On behalf of: the XANTUS Investigators Funding Acknowledgements: Bayer AG Background: Gender differences in outcomes have been seen in patients with atrial fibrillation (AF). Overall in the phase III ROCKET AF randomized controlled trial of rivaroxaban versus warfarin in stroke or systemic embolism prevention in patients with nonvalvular AF, women had a higher risk of stroke but a lower risk of vascular death and bleeding events than men. Recent registry data have also shown that women had a higher risk of stroke than men. Purpose: This study aimed to analyse demographics and clinical characteristics, and assess the impact of gender on rates of thromboembolism, bleeding and death, in patients with nonvalvular AF specifically receiving rivaroxaban in routine clinical practice. Methods: XANTUS is an international, prospective, observational study of consecutive consenting patients with nonvalvular AF newly started on rivaroxaban who were followed up at 3-month intervals for 1 year, or at least 30 days after permanent discontinuation; mean treatment duration was 329 days. The XANTUS database was examined for demographics, clinical characteristics and outcomes by patient gender. All major outcomes (including major bleeding, symptomatic thromboembolic events [stroke, systemic embolism (SE), transient ischaemic attack, myocardial infarction (MI)], and death) were centrally adjudicated. Results: Among the 6,784 patients in the safety population, the analysis was conducted in 4,016 male (59.2%) and 2,765 female (40.8%) patients (missing values for 3 patients). Women were older than men (mean age 73.7 vs 70.0 years; p<0.0001) and were more likely to have age-related comorbidities (e.g. prior stroke/SE/transient ischaemic attack: 20.7% vs 17.9%; p=0.005); men were more likely to have had prior MI (12.8% vs 6.2%; p<0.0001). After adjustment for baseline characteristics, analysis of outcomes by gender showed a similar risk of stroke/SE in both men and women (hazard ratio [HR] 1.04; 95% confidence interval [CI] 0.59–1.84), and nonsignificant trends for men to be at lower risk of ischaemic stroke (HR=0.79; 95% CI 0.39–1.61). Nonsignificant trends were also seen for higher risk of major bleeding (HR=1.32; 95% CI 0.90–1.95) and MI (HR=1.17; 95% CI 0.51–2.68) in men. Conclusion: Unlike other AF populations reported in the literature, outcomes in patients with nonvalvular AF treated with rivaroxaban were generally similar between men and women in this real-world study.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».