200Safety of uninterrupted dabigatran in cardiovascular interventions in the GLORIA-AF registry program
Notice bibliographique
Résumé
On behalf of: GLORIA-AF Investigators Funding Acknowledgements: The study was funded by Boehringer Ingelheim Background: Non-VKA oral anticoagulants (NOACs), such as dabigatran etexilate (DE), have become an important treatment option for patients with atrial fibrillation (AF). Cardiovascular (CV) interventions such as cardioversion and catheter ablation carry the risk of thromboembolic complications, while ablation is also associated with a risk of peri-procedural bleeding. A recent randomized, controlled clinical trial (RE-CIRCUIT) in patients undergoing AF ablation showed that an uninterrupted DE regimen was associated with fewer bleeding complications than uninterrupted warfarin with no difference in thromboembolic events1. Data from patients followed in routine clinical care inform clinical decision-making; however, prospectively collected data are not readily available. Purpose: This analysis describes the safety of uninterrupted DE for patients undergoing CV interventions in the prospectively collected clinical practice data from GLORIA-AF. Methods: GLORIA-AF is a prospective, observational, global registry program of consecutive patients with newly diagnosed non-valvular AF at risk of stroke. In Phase II of the program, DE patients were followed for 2-years. DE was prescribed and used at the discretion of treating physicians. CV interventions in patients on DE treatment that were performed without bridging, and for which information about the intra-procedure DE regimen (interrupted or uninterrupted) was available were included in the analysis. For the major subgroup of patients with an uninterrupted DE regimen, baseline characteristics, stroke/systemic embolism, and major bleeding up to 8 weeks after the intervention were described. Results: Patients were recruited at 982 sites in 44 countries from Nov 2011 to Dec 2014. During the 2-year follow-up of the 4859 eligible DE patients, 456 CV interventions were identified in the first DE treatment period. The majority of interventions (n=412) were performed with an uninterrupted DE regimen: 299 cardioversions, 38 catheter ablations, 25 pacemaker implantations, 26 angiographic procedures, 24 coronary/peripheral angioplasty ± stenting and other catheter-based interventions in 332 patients. Mean age of these patients was 67.2 (±9.6) years, 64.5% were male, 75.3% had hypertension, 28.6% heart failure and 20.8 % coronary disease. Mean CHA2DS2VASc score was 2.7 (±1.4). Within an average follow-up of 7.52 weeks after intervention, one major bleed and one systemic embolic event occurred on DE (risk 0.25% per intervention for both outcomes, 95% confidence interval (0.01%-1.36%). Conclusions: In this prospective analysis, the frequencies of major bleeding and stroke/systemic embolism following CV interventions with an uninterrupted DE regimen were very low. This supports the favorable safety and effectiveness profile of DE in clinical practice based settings, complementing randomized trial data. Reference: 1) Hugh Calkins et al. N Engl J Med 2017; 376:1627-1636
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| 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 ».