Original Article
Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation
N Engl J Med 2009; 360:2066-2078May 14, 2009
- Abstract
Background
Vitamin K antagonists reduce the risk of stroke in patients with atrial fibrillation but are considered unsuitable in many patients, who usually receive aspirin instead. We investigated the hypothesis that the addition of clopidogrel to aspirin would reduce the risk of vascular events in patients with atrial fibrillation.
Methods
A total of 7554 patients with atrial fibrillation who had an increased risk of stroke and for whom vitamin K–antagonist therapy was unsuitable were randomly assigned to receive clopidogrel (75 mg) or placebo, once daily, in addition to aspirin. The primary outcome was the composite of stroke, myocardial infarction, non–central nervous system systemic embolism, or death from vascular causes.
Results
At a median of 3.6 years of follow-up, major vascular events had occurred in 832 patients receiving clopidogrel (6.8% per year) and in 924 patients receiving placebo (7.6% per year) (relative risk with clopidogrel, 0.89; 95% confidence interval [CI], 0.81 to 0.98; P=0.01). The difference was primarily due to a reduction in the rate of stroke with clopidogrel. Stroke occurred in 296 patients receiving clopidogrel (2.4% per year) and 408 patients receiving placebo (3.3% per year) (relative risk, 0.72; 95% CI, 0.62 to 0.83; P<0.001). Myocardial infarction occurred in 90 patients receiving clopidogrel (0.7% per year) and in 115 receiving placebo (0.9% per year) (relative risk, 0.78; 95% CI, 0.59 to 1.03; P=0.08). Major bleeding occurred in 251 patients receiving clopidogrel (2.0% per year) and in 162 patients receiving placebo (1.3% per year) (relative risk, 1.57; 95% CI, 1.29 to 1.92; P<0.001).
Conclusions
In patients with atrial fibrillation for whom vitamin K–antagonist therapy was unsuitable, the addition of clopidogrel to aspirin reduced the risk of major vascular events, especially stroke, and increased the risk of major hemorrhage. (ClinicalTrials.gov number, NCT00249873.)
Media in This Article
Figure 1
Cumulative Incidence of Trial Outcomes, According to Treatment Group.Figure 2
Relative Risks for Various Subgroups, According to Treatment Group.Article Activity
- Article
Atrial fibrillation is a common cardiac arrhythmia that increases the risk of stroke by a factor of five.1 Adjusted-dose vitamin K antagonists and antiplatelet agents reduce the risk of stroke by 64% and 22%, respectively.2 As compared with aspirin, vitamin K antagonists reduce the risk of stroke by 38% but more than double the risk of intracranial hemorrhage and increase the risk of major extracranial hemorrhage by 70%. They do not reduce mortality from any cause or from vascular causes.2,3 On the basis of these data, vitamin K antagonists are recommended for patients at higher risk for stroke, and aspirin for patients at lower risk.4,5
Vitamin K antagonists have a narrow window for a therapeutic benefit and require regular monitoring of the international normalized ratio (INR).6 Several surveys in North America and Europe indicate that only about 50% of patients with atrial fibrillation who are at increased risk for stroke receive vitamin K antagonists.7-10 Patients may not be treated with a vitamin K antagonist for any number of reasons, including concern about interactions with other drugs, the increased risk of hemorrhage, inadequate compliance with INR monitoring, and a desire by the patient to avoid vitamin K–antagonist therapy. Most of these patients are treated with aspirin.
The benefit of combining clopidogrel with aspirin has been proven in patients with acute coronary syndromes.11 The Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE) was initiated to evaluate the role of clopidogrel plus aspirin for the prevention of stroke and other vascular events in patients with atrial fibrillation. ACTIVE W, which has previously been reported,12 compared clopidogrel plus aspirin with a vitamin K antagonist (ClinicalTrials.gov number, NCT00243178). ACTIVE A, reported here, compared clopidogrel plus aspirin with aspirin alone in patients with atrial fibrillation who were at increased risk for stroke and for whom therapy with a vitamin K antagonist was considered unsuitable.
Methods
Trial Design
The design of ACTIVE A has been described previously.13 The study was a randomized, double-blind, multicenter trial performed at 580 centers in 33 countries. The sponsors, Sanofi-Aventis and Bristol-Myers Squibb, assisted in protocol development and on-site monitoring but had no role in data collection or analysis or in the writing of the manuscript. A steering committee consisting of national coordinators, the principal investigators, and representatives of the sponsors supervised the trial. The study was coordinated by the Population Health Research Institute at McMaster University, which also managed and analyzed the data. The trial protocol was approved by ethics committees at all participating centers. The academic authors vouch for the accuracy and completeness of the data and the analyses.
Study Participants
Patients were eligible for ACTIVE (either ACTIVE A or ACTIVE W) if they had atrial fibrillation at enrollment or had had at least two episodes of intermittent atrial fibrillation in the previous 6 months. In addition, patients were required to have at least one of the following risk factors for stroke: an age of 75 years or more; systemic hypertension during treatment; previous stroke, transient ischemic attack, or non–central nervous system systemic embolism; a left ventricular ejection fraction of less than 45%; peripheral vascular disease; or an age of 55 to 74 years and diabetes mellitus or coronary artery disease. Patients were excluded if they required a vitamin K antagonist or clopidogrel or had any of the following risk factors for hemorrhage: documented peptic ulcer disease within the previous 6 months; a history of intracerebral hemorrhage; significant thrombocytopenia (platelet count <50×109 per liter); or ongoing alcohol abuse. All patients provided written informed consent before participating in the study.
Treatment Assignment and Follow-up
Patients who were considered to be candidates for vitamin K–antagonist therapy were enrolled in ACTIVE W, and those for whom such therapy was considered to be unsuitable were enrolled in ACTIVE A. Patients in both ACTIVE W and ACTIVE A could also be enrolled in ACTIVE I, involving factorial randomization to either irbesartan or placebo (NCT00249795). The ACTIVE I trial is ongoing.
By means of an interactive telephone system, patients in ACTIVE A were randomly assigned in equal numbers, in blocks of varying sizes, to receive clopidogrel at a dose of 75 mg or matching placebo once daily, in a double-blind fashion. All patients also received aspirin (recommended dose, 75 to 100 mg per day). The protocol specified that patients undergoing cardioversion at any point during the trial were to be treated with an open-label vitamin K antagonist for 4 weeks before and after cardioversion and were then to resume the assigned study treatment.
Follow-up visits for the assessment of compliance and outcome events were scheduled at 1 month and 3 months, every 3 months thereafter for the first year, and then every 6 months until the end of the trial. Follow-up for all surviving patients was continued until the final visit in November 2008.
Trial Outcomes
The primary study outcome was any major vascular event (stroke, non–central nervous system systemic embolism, myocardial infarction, or death from vascular causes). The most important secondary outcome was stroke. Other secondary outcomes were the other individual components of the primary outcome (non–central nervous system systemic embolism, myocardial infarction, and death from vascular causes) and the composite of the primary outcome and major hemorrhage.
Stroke was defined as the sudden onset of a focal neurologic deficit lasting more than 24 hours and classified as ischemic (including hemorrhagic transformation), hemorrhagic, or of uncertain type. The severity of stroke was assessed with the use of the modified Rankin scale (on which scores range from 0 to 6, with 0 indicating no symptoms and 6 indicating death) at the time of hospital discharge or within 7 days after the onset of stroke. The risk of stroke was assessed post hoc by means of the CHADS2 score, which reflects the risk of stroke in patients with atrial fibrillation, with values ranging from 0 to 6 and higher scores indicating an increased risk. Myocardial infarction was diagnosed according to standard guidelines.14 Death from vascular causes was defined as any death not clearly due to a nonvascular cause. Major hemorrhage was defined as any overt bleeding requiring transfusion of at least two units of blood or any overt bleeding meeting the criteria for severe hemorrhage, which included any of the following: fatal hemorrhage, a drop in the hemoglobin level of 5.0 g per deciliter or more, hypotension requiring inotropic agents, intraocular bleeding leading to substantial loss of vision, requirement for surgical intervention, symptomatic intracranial hemorrhage, or requirement for transfusion of four units or more of blood. Minor bleeding was defined as any nonmajor bleeding associated with modification of the study-drug regimen. All major outcomes were adjudicated by an event-adjudication committee, and all strokes by a neurologist; the committee members and the neurologists were unaware of the treatment assignments.
Statistical Analysis
The hypothesis being tested in ACTIVE A was that the use of clopidogrel plus aspirin would reduce the risk of the primary outcome, as compared with the use of aspirin alone. On the basis of an expected annual primary-event rate of 8% among patients treated with aspirin alone, we estimated that enrollment of 7500 patients during a period of 2 years would provide a statistical power of 88% to detect a relative reduction of 15% in the risk of major vascular events with the addition of clopidogrel to aspirin. The study was designed to accrue at least 1600 primary events.
An independent data and safety monitoring board periodically reviewed the efficacy and safety data. Stopping rules were based on modified Haybittle–Peto boundaries of 4 SD in the first half of the study and 3 SD in the second half for efficacy data and 3 SD in the first half of the study and 2 SD in the second half for safety data. Two formal interim analyses of efficacy were performed when 50% and 75% of the expected number of primary events had accrued; no correction of the reported P value for these interim tests was performed.
All analyses were based on the intention-to-treat principle. Data for patients lost to follow-up were censored at the time of the last date of contact. Kaplan–Meier curves were plotted for each of the two treatment groups and were compared by means of a log-rank test. Cox proportional-hazards models stratified by treatment assignment in ACTIVE I were used to calculate relative risks (hazard ratios) and 95% confidence intervals. A test of interaction between the treatment groups of ACTIVE A and those of ACTIVE I was performed by the data and safety monitoring board, which reported no significant interaction for the primary outcome or for major bleeding. Additional Cox models were used to evaluate interactions between treatment assignment and other subgroups of interest.
Results
A total of 7554 patients were enrolled in ACTIVE A between June 2003 and May 2006 and were randomly assigned to receive clopidogrel (3772 patients) or placebo (3782 patients) in addition to aspirin; all patients received at least one dose of the assigned study medication (clopidogrel or placebo). Forty-three patients (<1%) were lost to follow-up, which ended in November 2008. The median duration of follow-up for both groups was 3.6 years.
Study Population
Table 1Table 1
Baseline Characteristics of the Study Patients, According to Treatment Group. lists the baseline characteristics of the patients. The mean age was 71 years; 58.2% of the patients were men. Atrial fibrillation was permanent in 63.7%, persistent in 14.0%, and paroxysmal in 22.1%. The mean CHADS2 score was 2.0. At baseline, 82.7% of patients were receiving aspirin, and 8.5% were taking a vitamin K antagonist. Reasons given for enrollment in ACTIVE A were a specific risk of bleeding (for 22.9% of patients), no such risk but a physician's judgment that a vitamin K antagonist was inappropriate for the patient (49.7%), and the patient's preference not to take a vitamin K antagonist as the sole reason (26.0%) (Table 1).Adherence to the Treatment Regimens
Rates of discontinuation of the study medication were 16.3% and 15.2% for clopidogrel and placebo, respectively, at 1 year, increasing to 39.4% and 37.1% at 4 years. All patients were receiving aspirin at the time of randomization, with use decreasing in both groups to 92.9% at 1 year and 81.1% at 4 years. At baseline, the daily dose of aspirin used was 75 to 100 mg in 96.0% of patients and more than 100 mg in 3.5%. The most common antithrombotic medications used by patients who permanently discontinued the study medication were vitamin K antagonists (taken by 29.4% of patients in the clopidogrel group and 31.0% in the placebo group) and aspirin alone (25.1% in the clopidogrel group and 23.6% in the placebo group). A total of 777 patients (10.3%) received a vitamin K antagonist after discontinuation of the trial medication.
Outcomes
The primary end point occurred in 832 patients receiving clopidogrel (6.8% per year) as compared with 924 patients receiving placebo (7.6% per year) (relative risk, 0.89; 95% confidence interval [CI], 0.81 to 0.98; P=0.01) (Table 2Table 2
Relative Risks of Primary and Secondary Outcomes, According to Treatment Group. and Figure 1AFigure 1Cumulative Incidence of Trial Outcomes, According to Treatment Group.). The reduction in the risk of major vascular events in the clopidogrel group was primarily due to a reduction in the incidence of stroke. Stroke occurred in 296 patients receiving clopidogrel (2.4% per year) and 408 patients receiving placebo (3.3% per year) (relative risk, 0.72; 95% CI, 0.62 to 0.83; P<0.001) (Table 2 and Figure 1B). Myocardial infarction occurred in 90 patients receiving clopidogrel (0.7% per year) and in 115 patients receiving placebo (0.9% per year; relative risk, 0.78; 95% CI, 0.59 to 1.03; P=0.08).Annual rates of non–central nervous system systemic embolism and death from vascular causes were similar between the two groups. A total of 1666 deaths occurred, including 163 fatal strokes, which accounted for 9.8% of all deaths. Other major causes of death included death from nonvascular causes (28.0% of all deaths), arrhythmia (20.9%), and heart failure (18.7%). There were 69 fatal hemorrhages, which accounted for 4.1% of all deaths. The total number of days of hospitalization for cardiovascular causes was 30,276 for clopidogrel plus aspirin and 34,813 for aspirin alone.
Types and Severity of Stroke
The rate of ischemic stroke was significantly lower in the clopidogrel group than in the placebo group (1.9% per year vs. 2.8% per year, P<0.001) (Table 2). There was a nonsignificant increase in the rate of hemorrhagic stroke in association with the addition of clopidogrel, from 0.17% to 0.23% per year. The risk of stroke of any severity, as measured by means of the modified Rankin score, was reduced with the use of clopidogrel plus aspirin. The addition of clopidogrel prevented the occurrence of 46 nondisabling strokes (modified Rankin score, 0 to 2) and 69 disabling or fatal strokes (modified Rankin score, 3 to 6). There was a net decrease of 23 fatal strokes with the addition of clopidogrel, as a result of 26 fewer fatal strokes of ischemic or uncertain cause and 3 more fatal hemorrhagic strokes.
Hemorrhage
Major bleeding occurred in 251 patients receiving clopidogrel as compared with 162 patients receiving placebo (2.0% per year vs. 1.3% per year; relative risk, 1.57; 95% CI, 1.29 to 1.92; P<0.001) (Table 3Table 3
Relative Risks of Hemorrhage, According to Treatment Group.). With clopidogrel, there was an excess of 83 episodes of major bleeding not related to stroke (62 of which were severe), including an excess of 13 fatal episodes. The most common site of hemorrhage was the gastrointestinal tract (132 episodes with clopidogrel vs. 68 with placebo, for an excess of 64 episodes with clopidogrel). With the combination of major vascular events (the primary outcome) and major hemorrhage, there was no significant difference between the overall event rate with aspirin plus clopidogrel and the rate with aspirin alone (968 vs. 996 events; relative risk, 0.97; 95% CI, 0.89 to 1.06; P=0.54).Subgroup Analyses
Subgroup analyses were performed for major vascular events (the primary outcome) (Figure 2AFigure 2
Relative Risks for Various Subgroups, According to Treatment Group.) and stroke (Figure 2B). Although there appeared to be a significant interaction relating both age and the CHADS2 score to the effect of clopidogrel on major vascular events, this interaction was not evident for stroke. In addition, an interaction with baseline use of vitamin K antagonists was found with regard to stroke but not vascular events. The lack of consistency in these interactions indicates that there was only weak evidence of differential treatment effects according to these subgroups.Discussion
In ACTIVE A, we compared the combination of aspirin plus clopidogrel with aspirin alone for the prevention of major vascular events in patients with atrial fibrillation who had an increased risk of stroke and in whom therapy with a vitamin K antagonist was considered to be unsuitable. The addition of clopidogrel to aspirin reduced the rate of major vascular events from 7.6% per year to 6.8%. This was primarily due to a reduction in the rate of stroke. The rate of major hemorrhage increased with the addition of clopidogrel, from 1.3% to 2.0% per year.
It is useful to compare the risk–benefit ratios for clopidogrel plus aspirin versus aspirin and vitamin K antagonists versus aspirin. In a meta-analysis, as compared with aspirin, warfarin reduced the risk of stroke by 38% and increased the risks of major extracranial hemorrhage by 70% and intracranial hemorrhage by 128%.2 In ACTIVE A, clopidogrel plus aspirin reduced the risk of stroke by 28% and increased the risk of major extracranial hemorrhage by 51% and major intracranial hemorrhage by 87%. This comparison suggests that therapy with a vitamin K antagonist is more effective than clopidogrel plus aspirin but is associated with a greater risk of hemorrhage, although the patient populations and concomitant therapies in ACTIVE A and the meta-analysis trials are not completely comparable.
Myocardial infarction was not a common outcome in ACTIVE A (115 events in the placebo group and 90 in the clopidogrel group). The difference in the rate of myocardial infarction between the two groups, although not significant (P=0.08), is plausible because it is consistent with the results of previous trials involving patients with acute coronary syndromes.11,15 It might at first seem surprising that the 28% reduction in stroke found in ACTIVE A did not result in a significant reduction in mortality from vascular causes or from any cause. However, the use of vitamin K antagonists has been shown to reduce the rate of stroke by 38% as compared with the use of aspirin, with no significant effect on mortality.2 Given that only 10% of the 1666 deaths in ACTIVE A were due to stroke, it is unlikely that any intervention that primarily reduces the risk of stroke will significantly reduce mortality. The majority of deaths were related to arrhythmia (21%), heart failure (19%) and nonvascular causes (28%).
In patients with atrial fibrillation, there is evidence of both a hypercoagulable state and increased platelet activation.16 Markers of coagulation activation and thrombin generation are elevated in patients with atrial fibrillation and are suppressed with the use of vitamin K antagonists.17-19 Markers of platelet activation, such as soluble P-selectin, are also elevated in patients with atrial fibrillation.20-23 In the Rotterdam Study of elderly patients, there was a strong independent association between the soluble P-selectin level and mortality from cardiac causes in patients with atrial fibrillation.22 The role of platelet activation in stroke in patients with atrial fibrillation has been questioned because of the modest protective effect of aspirin against stroke.2 However, some patients with atrial fibrillation who are receiving aspirin may have only partial inhibition of platelet aggregation.24 The addition of clopidogrel to aspirin in patients with atrial fibrillation results in a significantly greater reduction in platelet aggregation than that observed with aspirin alone,25 suggesting that more effective platelet inhibition could augment the protective effect of aspirin. The results of ACTIVE A confirm this hypothesis and provide strong evidence for an important role of abnormal platelet activation in the pathogenesis of stroke in patients with atrial fibrillation.
It is important to emphasize that oral anticoagulation therapy with a vitamin K antagonist is the preferred and recommended therapy for the prevention of ischemic stroke in patients with atrial fibrillation who are at increased risk for stroke.4,5 However, current guidelines also note that “the selection of the antithrombotic agent should be based upon the absolute risks of stroke and bleeding and the relative risk and benefit for a given patient,”5 a specification for which precise guidance is not available. Patients were eligible for ACTIVE A if, in addition to being at increased risk for stroke, they were not considered to be candidates for vitamin K–antagonist therapy. At baseline, only 8.5% of patients in ACTIVE A were receiving a vitamin K antagonist, as compared with 77% in ACTIVE W. Therefore, the decision to enroll a patient in ACTIVE A or ACTIVE W was generally consistent with a preexisting clinical judgment.
In ACTIVE W, therapy with a vitamin K antagonist reduced the rate of stroke by 42% as compared with therapy with clopidogrel plus aspirin. This reduction is similar to the 38% reduction in the rate of stroke with vitamin K antagonists as compared with aspirin alone, reported in the meta-analysis of warfarin trials.2 These two findings, taken together, would seem to suggest that there should be little or no difference in efficacy between clopidogrel plus aspirin and aspirin alone, a conclusion that is inconsistent with the significant 28% reduction in the risk of stroke shown in ACTIVE A. However, most patients in ACTIVE W (77%) had previously been treated with a vitamin K antagonist. Among the patients in ACTIVE W who were not receiving a vitamin K antagonist at the time of enrollment, the reduction in the rate of stroke was only 29%.
In conclusion, we found that treatment with clopidogrel plus aspirin, as compared with aspirin alone, reduced the rate of major vascular events among patients with atrial fibrillation who were at increased risk for stroke and for whom therapy with a vitamin K antagonist was considered to be unsuitable. This reduction was primarily due to a reduction in the risk of stroke. There was a significant increase in the risk of major hemorrhage.
Supported by grants from Sanofi-Aventis and Bristol-Myers Squibb.
Dr. Connolly reports receiving consulting fees, lecture fees, and grant support from Sanofi-Aventis, Bristol-Myers Squibb, and Boehringer Ingelheim and grant support from Portola Pharmaceuticals; Dr. Hohnloser, consulting fees, lecture fees, and grant support from Sanofi-Aventis and Bristol-Myers Squibb, consulting fees from Cardiome and ARYx Therapeutics, and lecture fees and grant support from St. Jude Medical; Dr. Pfeffer, consulting fees and grant support from Sanofi-Aventis and Bristol-Myers Squibb; Dr. Yusuf, consulting fees, lecture fees, and grant support from Sanofi-Aventis and Bristol-Myers Squibb, consulting fees and lecture fees from AstraZeneca and Boehringer Ingelheim, and lecture fees and grant support from GlaxoSmithKline. No other potential conflict of interest relevant to this article was reported.
The members of the writing group (Stuart J. Connolly and Janice Pogue, Population Health Research Institute, Hamilton, ON, Canada; Robert G. Hart, University of Texas Health Center, San Antonio; Stefan H. Hohnloser, Goethe University Hospital, Frankfurt, Germany; Marc Pfeffer, Brigham and Women's Hospital, Boston; and Susan Chrolavicius and Salim Yusuf, Population Health Research Institute, Hamilton, ON, Canada) of Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE) assume responsibility for the overall content and integrity of the article.
This article (10.1056/NEJMoa0901301) was published at NEJM.org on March 31, 2009.
Source Information
Address reprint requests to Dr. Connolly at the Population Health Research Institute, McMaster University, 237 Barton St. E., Hamilton, ON L8L 2X2, Canada, or at stuart.connolly@phri.ca.
The Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE) investigators are listed in the Appendix.
Appendix
The ACTIVE committee members and investigators are as follows: Operations Committee: S.J. Connolly (principal investigator), S. Yusuf (steering committee chair), J. Camm, S. Chrolavicius (project manager), P. Commerford, M. Flather, R.G. Hart, S.H. Hohnloser, C. Joyner (chair of event adjudication committee), M. Pfeffer, C. Gaudin (sponsor representative), M. Blumenthal (sponsor representative), C. Marchese (sponsor representative); Writing Group: S.J. Connolly, J. Pogue, S. Chrolavicius, R. Hart, M. Pfeffer, S. Hohnloser, S. Yusuf; Steering Committee: I. Anand, H. Arthur, A. Avezum, A. Budaj, L. Ceremuzynski, R. De Caterina, R. Diaz, P. Dorian, G. Flaker, K.A.A. Fox, M.G. Franzosi, S. Goldhaber, S. Golitsyn, C. Granger, D. Halon, A. Hermosillo, D. Hunt, P. Jansky, N. Karatzas, M. Keltai, O. Kozan, F. Lanas, C.P. Lau, J.Y. Le Heuzey, B.S. Lewis, J. Morais, C. Morillo, E. Paolasso, R.J. Peters, M. Pfisterer, L. Piegas, A. Pipilis, E. Sitkei, K. Swedberg, M. Talajic, V. Valentin, W. Van Mieghem, J. Varigos, plus members of the operations committee; Events Adjudication Committee: S. Ameriso, M. Atra, A. Avezum, O. Berwanger, C. Bonilla, N. Bornstein, A. Budaj, T. Chamiec, Y.K. Chan, Y. Cottin, L. Csiba, J. Cybulski, A. Czepiel, H. De Raedt, R. Diaz, H. Dvorakova, J. Eikelboom, O. Ergene, G. Fodor, M. Galli, E. Gardinale, S. Golitsyn, C. Granger, B. Gross, P. Goodfield, D. Halon, O. Happola, J. Healey, D. Himbert, D. Hunt, F. Jacobsson, P. Jansky, P. Kalvach, N. Karatzas, M. Keltai, B. Kies, M. Laine, A. Lam, J.Y. Le Heuzey, B.S. Lewis, S. Lewis, D. Leys, A.P. Maggioni, A. Massaro, B.M. Mayosi, B. Norrving, T. Okay, L. Olah, J.O. Osende, A. Oto, A. Peeters, M. Penicka, A. Perakis, L. Piegas, A. Pipilis, G. Pizzolato, F. Rafti, J. Renkin, A. Siva, P.G. Steg, B. Stockins, E. Strozynska, K. Swedberg, F. Turazza, L. Vanderhoven, S. Vizel, P. Widimsky, J. Zaborski; Stroke Advisory Committee: G. Albers, G. Hankey, R.G. Hart, B. Norrving, A. Shuaib, J. Silva; Data Safety Monitoring Board: D.G. Wyse (chair) J.A. Cairns, M. Gent, J. Hirsh, J. Marler, E. Pritchett, J. Wittes; Project Office: H. Beresh (research coordinator), L. Floyd, Z. Gasic, I. Holadyk-Gris, M. Lawrence (events adjudication coordinator), I. Moro, S. Perry, J. Roberts, T. Rodrigues, L. Robinson, C. Stevens, L. Worthy, F. Yuan; Investigators who recruited at least 3 patients (number of patients enrolled in each country): Argentina (517): R.A. Ahuad Guerrero, O. Allall, L.M. Amuchastegui, M. Boskis, M.H. Bustamante Labarta, C.R. Castellanos, P. Chiale, C.A. Cuneo, A. Czcczuo, A.J. Gabito, M. Garrido, L.A. Guzmán, E.G. Hasban, A.R. Hershson, M.A. Hominal, J.G. Krauss, H.L. Luciardi, E.M. Marzetti, O.R. Montaña, R.F. Rabinovich, H.R. Ramos, A.S. Sanchez, P.O. Schygiel, G.M. Sumay, D.R. Vogel, C.J. Zaidman; Australia (182): G.M. Aroney, D.T. Ashby, M.A. Barlow, P. Cooke, D.B. Cross, M.A. Fitzpatrick, P. Garrahy, J. Karrasch, G.I. Nelson, D. Rees, S.D. Roger, J. Rogers, B.B. Singh, J.F. Stickland, J.H. Waites, W.F. Walsh; Austria (55): J. Eichinger, K. Huber, F. Leisch; Belgium (119): J. Boland, V.M. Conraads, F.J.C. Cools, L. De Roy, D. El Allaf, G.H. Mairesse, B. Vankelecom; Brazil (662): J. Abrantes, D. Armaganijan, J. Atié, C. Blacher, L.C. Bodanese, J.C.F. Braga, M.V. Braile, H. Chaves, O.R. Coelho, C.L.P. Cunha, G.G. De Lima, A.A.V. de Paola, J.P. Esteves, A. Francischetti, A.E. Francischetti, A.M. Lorga-Filho, L.N. Maia, D.M. Marcussi, J.A. Marin-Neto, Z.M. Meneghelo, R. Mourilhe Rocha, P.R. Nogueira, W. Oigman, M. Paiva, D.B. Précoma, W. Rabelo, A. Rabelo, Jr., S. Rassi, A. Rassi, Jr., G. Reis, P.R. Rossi, J.M. Rossi Neto, J.K. Saraiva, D.C. Sobral-Filho, S.L. Zimmermann; Canada (304): T.A. Ashton, R. Bhargava, S. Carroll, R. Chehayeb, S.P. Connors, C. Constance, P. Costi, B. Coutu, E. Crystal, J.D. Douketis, C. Fortin, B.A. Fox, M.K. Gupta, A.D. Krahn, R. Kuritzky, K. Kwok, R. Leader, P. Ma, I. Mangat, C.R. Maranda, M.F. Matangi, G. Moddel, A. Mukherjee, S. Nawaz, M. Palaic, A.S. Pandey, T.M. Rebane, M. Ruel, J.L. Sapp, M.P. Senaratne, R. St-Hilaire, P. Talbot, T.B. To, M. Vakani, M.A. Weigel, Z. Wulffhart, L. Yao, D. Zaniol; Chile (160): C.R. Conejeros, R. Corbalán, G.R. Dussaillant, E. Escobar, M.E. Hassi, C.A. Parra, B.A. Stockins, P.E. Varleta; Czech Republic (426): L. Berka, V. Dedek, J. Florian, O. Hejhal, M. Herold, Z. Klimsa, I. Kotik, J. Simon, K. Smetana, J. Spinar, L. Špinarová, F. Tousek; Denmark (39): S. Husted, T. Nielsen, S. Pehrson, C. Tuxen; Finland (58): V.P. Harjola, H.V. Huikuri, R.V.J. Kettunen, J.H. Melin, K. Peuhkurinen; France (171): R. Carlioz, D. Coisne, E. Decoulx, P. Defaye, J.M. Demarcq, K. Gacem, D.L. Galley, H.M. Lardoux, P. Mabo, M. Mansour, T.G. Olive, J.E. Poulard, C.F. Pruvot, J.L. Rey; Germany (747): W.R. Bauer, G. Baumann, G. Berghöfer, G. Boehm, M.M. Borggrefe, G. Brücker, H. Darius, G.Z. Duray, S.B. Felix, P. Fink, H. Fritz, R. Haberl, S. Hoffmann, T. Horacek, D.W. Kalusche, W. Kasper, H.A. Katus, H.H. Klepzig, U. Loos, R. Merher, T. Munzel, J. Neuzner, H.R. Ochs, B. Pieske, B.W. Pollock, A. Schmidt, M. Schumacher, K. Seidl, U. Speier, S.G. Spitzer, G. Stenzel, H. Volkmann, J. Wunderlich, U. Zacharzowsky; Greece (91): H. Antonakoudis, N. Georgakopoulos, J.A. Goudevenos, T.A. Iliopoulos, I. Kallikazaros, V.N. Pyrgakis, P. Skoufas; Hong Kong (86): W.K. Chan, H.W. Chan, J.W.H. Fung, S.K. Li, K.S. Wong; Hungary (218): T. Forster, P. Kárpáti, K. Keltai, A. Kovacs, G. Kurta, Z. Laszlo, J. Rapi, L. Regos, L. Rostas, I. Szakál, J. Tomcsanyi, C. Toth; Israel (124): L. Bloch, N. Khader, E. Klainman, D. Koukoui, C. Lotan, A. Marmor, M.Z. Omary, L.H. Reisin, Z. Vered, D. Zeltser, R. Zimlichman; Italy (291): L. Bianconi, D. Bicego, D. Cosmi, F. Filigheddu, A. Garini, M. Lunati, L. Moretti, L. Mos, A.E. Pontiroli, G. Renda, S. Ricci, P. Rossi, M. Santonastaso, G.A. Scioli, M. Stramba-Badiale, P. Terrosu; Malaysia (26): R. Omar, T.K. Ong, W.A. Wan Ahmad; Mexico (223): R. Alvarado, C. Calvo, J.A. Cordero-Cabra, I. Hernández, C. Jerjes-Sanchez, S. Lara, E. Lopez Rosas, L. Molina, E. Morales, F. Petersen-Aranguren, E.M. Picos Bovio, G. Pozas, F.J. Robles Torres; the Netherlands (101): K. Holwerda, D.J.A. Lok, R. Nierop, M.G.C. Pieterse, R. van der Heijden, L. van Kempen; Norway (34): B.K. Oie, T.M. Omland, J. Otterstad, C. von Brandis; Poland (1061): M. Bronisz, K. Chizynski, T. Czerski, M. Dluzniewski, J. Gessek, A. Gieroba, J.R. Gniot, J. Gorny, H. Halaczuiewicz, K. Janik, M. Janion, O. Jerzykowska, T. Kawka-Urbanek, K. Kincel, S. Kocon, J. Kopaczewski, W. Krasowski, M. Makuch, S. Malinowski, Z. Miastkowski, M. Mickiewicz-Pawlowska, P. Miekus, E. Obrebska-Tabaczka, M. Ogorek, E. Piasecka-Krysiak, A.W. Piepiorka, W. Piotrowski, W. Pluta, E. Puzio, J. Rekosz, W. Sinkiewicz, M. Stopinski, R. Szelemej, M. Tendera, M. Trusz-Gluza, M. Wilkoszynski, B. Zalska; Portugal (46): E. Antunes, M.O. Carrageta, J. de Sousa, L. Martins, M.I. Mendonca, I. Silvestre; Russia (655): E.V. Akatova, V. Aleksandrov, E.A. Antuch, G. Arutyunov, B. Bart, Y.B. Belousov, I.I. Chernichka, P. Dovgalevsky, N. Gratsiansky, A.Y. Ivleva, O.A. Kislyak, V.Y. Mareyev, E.B. Maykov, V. Milyagin, T.N. Novikova, E.P. Panchenko, O. Reshetko, E. Semernin, B.A. Sidorenko, A. Sinopalnikov, V. Skvortsova, A. Solomatin, T.S. Sukhinina, Z.A. Suslina, Y. Titkov, V. Tsyrline; Singapore (38): B. Chan, D. Foo, A.R. Omar, W.S. Teo; South Africa (128): B.G. Brown, I.O. Ebrahim, G.J. Gibson, E. Klug, J.D. Marx, P.S. Mntla, A. Okreglicki, M. Pretorius, J.S. Roos, F. Snyders, L.J. van Zyl; Spain (80): L. Cano, J. Garcia-Puig, A. Hernandez-Madrid, J.M. Mostaza, M.D. Orriach, X. Sabate, X. Viñolas; Sweden (98): P. Blomström, F. Jacobsson, L. Johansson, L. Klintberg, M. Lycksell, O. Nilsson, G. Rasmanis, K.E. Saldeen Nilehn, G. Ulvenstam; Switzerland (37): R.W. Baumgartner, M. François, A. Gallino, T. Moccetti, B.E. Tettenborn; Taiwan (172): H.-T. Chou, J.-Y. Kuo, W.-T. Lai, J.L. Lin, L.-J. Lin, K.C. Ueng, D.-F. Yeih; Turkey (22): M. Bakar, B. Ilerigelen, E. Kumral, Y. Nisanci, Z.I. Savas; United Kingdom (149): Y. Adgey, M.J. Brack, J. Cleland, P.P. Davey, J. Davies, S.K. Glen, K. Jennings, T. Levy, G.Y.H. Lip, A.J. Moriarty, C. Pearson, J.A. Purvis, M.P. Pye, I. Savelieva, R. Senior, T.G. Trouton; United States (434): I.S. Ahmed, M. Amin, J.L. Anderson, R.A. Bauernfeind, K. Belew, S.D. Bilazarian, R.A. Black, M.E. Burton, J.E. Cebe, Y.S. Chandrashekhar, C. Chen, D. Das, D.M. Denny, V. Desai, R.N. Fahmy, G.J. Fishbein, M.D. Gelernt, J. Gerber, M.C. Goldberg, P.G. Grena, M.B. Honan, J.J. Hunter, J. Jacobson, N.F. Jarmukli, K. Klancke, J.F. Kobayashi, S.J. Lewis, T. Little, I. Mallis, A.M. Marani, J.J. Marshall, P. Meltzer, F.J. Menapace, P.G. O'Neill, D.J. Pearce, A. Quick, S. Ravipudi, E. Rivera, M. Sackett, D.M. Salerno, A. Schussheim, K. Sheikh, U.R. Shettigar, C.B. Treasure, H. Vidaillet, N. Vijay, D. Wagner, J.L. Walker, S.L. Winters, D.R. Young, R.G. Zoble.
- References
References
1
Wolf PA ,Abbott RD ,Kannel WB . Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-988
CrossRef | Web of Science | Medline2
Hart RG ,Pearce LA ,Aguilar MI . Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146:857-867
Web of Science | Medline3
van Walraven C ,Hart RG ,Singer DE , et al. Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis. JAMA 2002;288:2441-2448
CrossRef | Web of Science | Medline4
Singer DE ,Albers GW ,Dalen JE , et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008;133:Suppl:546S-592S
CrossRef | Web of Science | Medline5
Fuster V ,Ryden LE ,Cannom DS , et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation -- executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). J Am Coll Cardiol 2006;48:854-906[Erratum, J Am Coll Cardiol 2007;50:562.]
CrossRef | Web of Science | Medline6
Connolly SJ ,Eikelboom J ,O'Donnell M ,Pogue J ,Yusuf S . Challenges of establishing new antithrombotic therapies in atrial fibrillation. Circulation 2007;116:449-455
CrossRef | Web of Science | Medline7
Hylek EM ,D'Antonio J ,Evans-Molina C ,Shea C ,Henault LE ,Regan S . Translating the results of randomized trials into clinical practice: the challenge of warfarin candidacy among hospitalized elderly patients with atrial fibrillation. Stroke 2006;37:1075-1080
CrossRef | Web of Science | Medline8
Birman-Deych E ,Radford MJ ,Nilasena DS ,Gage BF . Use and effectiveness of warfarin in Medicare beneficiaries with atrial fibrillation. Stroke 2006;37:1070-1074
CrossRef | Web of Science | Medline9
Waldo AL ,Becker RC ,Tapson VF ,Colgan KJ . Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation. J Am Coll Cardiol 2005;46:1729-1736
CrossRef | Web of Science | Medline10
Go AS ,Hylek EM ,Borowsky LH ,Phillips KA ,Selby JV ,Singer DE . Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. Ann Intern Med 1999;131:927-934
Web of Science | Medline11
The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators
Full Text | Web of Science | Medline12
ACTIVE Writing Group of the ACTIVE Investigators
CrossRef | Web of Science | Medline13
Connolly SJ ,Yusuf S ,Budaj A , et al. Rationale and design of ACTIVE: the Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events. Am Heart J 2006;151:1187-1193
CrossRef | Web of Science | Medline14
Cannon CP ,Battler A ,Brindis RG , et al. American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes: a report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee). J Am Coll Cardiol 2001;38:2114-2130
CrossRef | Web of Science | Medline15
COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) Collaborative Group
CrossRef | Web of Science | Medline16
Watson T ,Shantsila E ,Lip GYH . Mechanisms of thrombogenesis in atrial fibrillation: Virchow's triad revisited. Lancet 2009;373:155-166
CrossRef | Web of Science | Medline17
Mitusch R ,Siemens HJ ,Garbe M ,Wagner T ,Sheikhzadeh A ,Diederich KW . Detection of a hypercoagulable state in nonvalvular atrial fibrillation and the effect of anticoagulant therapy. Thromb Haemost 1996;75:219-223
Web of Science | Medline18
Lip GY ,Lowe GD ,Rumley A ,Dunn FG . Increased markers of thrombogenesis in chronic atrial fibrillation: effects of warfarin treatment. Br Heart J 1995;73:527-533
CrossRef | Web of Science | Medline19
Li-Saw-Hee FL ,Blann AD ,Lip GY . Effects of fixed low-dose warfarin, aspirin-warfarin combination therapy, and dose-adjusted warfarin on thrombogenesis in chronic atrial fibrillation. Stroke 2000;31:828-833
CrossRef | Web of Science | Medline20
Atalar E ,Haznedaroglu IC ,Acil T , et al. Patients with paroxysmal atrial fibrillation but not paroxysmal supraventricular tachycardia display evidence of platelet activation during arrhythmia. Platelets 2003;14:407-411
CrossRef | Web of Science | Medline21
Yamauchi K ,Furui H ,Taniguchi N ,Sotobata I . Plasma beta-thromboglobulin and platelet factor 4 concentrations in patients with atrial fibrillation. Jpn Heart J 1986;27:481-487
CrossRef | Medline22
Heeringa J ,Conway DS ,van der Kuip DA , et al. A longitudinal population-based study of prothrombotic factors in elderly subjects with atrial fibrillation: the Rotterdam Study 1990-1999. J Thromb Haemost 2006;4:1944-1949
CrossRef | Web of Science | Medline23
Kamath S ,Chin BS ,Blann AD ,Lip GY . A study of platelet activation in paroxysmal, persistent and permanent atrial fibrillation. Blood Coagul Fibrinolysis 2002;13:627-636
CrossRef | Web of Science | Medline24
Helgason CM ,Hoff JA ,Kondos GT ,Brace LD . Platelet aggregation in patients with atrial fibrillation taking aspirin or warfarin. Stroke 1993;24:1458-1461
CrossRef | Web of Science | Medline25
Muller I ,Massberg S ,Zierhut W , et al. Effects of aspirin and clopidogrel versus oral anticoagulation on platelet function and on coagulation in patients with nonvalvular atrial fibrillation (CLAFIB). Pathophysiol Haemost Thromb 2002;32:16-24
CrossRef | Web of Science | Medline
- Citing Articles (190)
Citing Articles
1
Freek W.A. Verheugt. (2012) Anticoagulant management in the cardiovascular setting. Fundamental & Clinical Pharmacology 26:1, 11-15
CrossRef2
Davide Capodanno, Dominick J. Angiolillo. (2012) Antithrombotic Pharmacotherapy in the Elderly: General Issues and Clinical Conundrums. Current Treatment Options in Cardiovascular Medicine 14:1, 57-68
CrossRef3
Hans-Christoph Diener, Ralph Weber, Gregory Y.H. Lip, Stefan H. Hohnloser. (2012) Stroke prevention in atrial fibrillation. Current Opinion in Neurology 25:1, 27-35
CrossRef4
Ilyas Mohammed, Adam Mohmand-Borkowski, James F. Burke, Peter R. Kowey. (2012) Stroke prevention in atrial fibrillation. Journal of Cardiovascular Medicine 13:2, 73-85
CrossRef5
Athanasios J. Manolis, Enrico Agabiti Rosei, Antonio Coca, Renata Cifkova, Serap E. Erdine, Sverre Kjeldsen, Gregory Y.H. Lip, Krzysztof Narkiewicz, Gianfranco Parati, Josep Redon, Roland Schmieder, Costas Tsioufis, Giuseppe Mancia. (2012) Hypertension and atrial fibrillation. Journal of Hypertension 30:2, 239-252
CrossRef6
Joan Chen, Yuhong Cathy Yuan, Grigorios I. Leontiadis, Colin W. Howden. (2012) Recent Safety Concerns With Proton Pump Inhibitors. Journal of Clinical Gastroenterology 46:2, 93-114
CrossRef7
Francis K L Chan. (2012) Anti-platelet therapy and managing ulcer risk. Journal of Gastroenterology and Hepatology 27:2, 195-199
CrossRef8
Robert W. Harrison, Kenneth W. Mahaffey. (2012) Clopidogrel and PPI Interaction: Clinically Relevant or Not?. Current Cardiology Reports 14:1, 49-58
CrossRef9
Thomas Höchtl, Kurt Huber. (2012) New anticoagulants for the prevention of stroke in atrial fibrillation. Fundamental & Clinical Pharmacology 26:1, 47-53
CrossRef10
Sana M. Al-Khatib, John H. Alexander, Renato D. Lopes, Kenneth W. Mahaffey, Manesh R. Patel, Christopher B. Granger. (2012) Promise of Factor Xa Inhibition in Atrial Fibrillation. Current Cardiology Reports 14:1, 70-78
CrossRef11
Giulio Coluzzi, Eliano Pio Navarese, Felicita Andreotti. (2012) EuroThrombosis: annual meeting of the European Society of Cardiology Working Group on Thrombosis. Expert Review of Hematology 5:1, 39-42
CrossRef12
Hans-Christoph Diener, John Eikelboom, Stuart J Connolly, Campbell D Joyner, Robert G Hart, Gregory YH Lip, Martin O'Donnell, Stefan H Hohnloser, Graeme J Hankey, Olga Shestakovska, Salim Yusuf. (2012) Apixaban versus aspirin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a predefined subgroup analysis from AVERROES, a randomised trial. The Lancet Neurology
CrossRef13
Yong-Jun Wang, Su-Ming Zhang, Liqun Zhang, Chun-Xue Wang. (2012) Chinese Guidelines for the Secondary Prevention of Ischemic Stroke and Transient Ischemic Attack 2010. CNS Neuroscience & Therapeutics 18:2, 93-101
CrossRef14
Robert Janknegt, Lex Ruiters, Hugo ten Cate. (2012) InforMatrix: ADP antagonists in acute coronary syndromes. Expert Opinion on Pharmacotherapy1-29
CrossRef15
P. Kirchhof, G. Y. H. Lip, I. C. Van Gelder, J. Bax, E. Hylek, S. Kaab, U. Schotten, K. Wegscheider, G. Boriani, A. Brandes, M. Ezekowitz, H. Diener, L. Haegeli, H. Heidbuchel, D. Lane, L. Mont, S. Willems, P. Dorian, M. Aunes-Jansson, C. Blomstrom-Lundqvist, M. Borentain, S. Breitenstein, M. Brueckmann, N. Cater, A. Clemens, D. Dobrev, S. Dubner, N. G. Edvardsson, L. Friberg, A. Goette, M. Gulizia, R. Hatala, J. Horwood, L. Szumowski, L. Kappenberger, J. Kautzner, A. Leute, T. Lobban, R. Meyer, J. Millerhagen, J. Morgan, F. Muenzel, M. Nabauer, C. Baertels, M. Oeff, D. Paar, J. Polifka, U. Ravens, L. Rosin, W. Stegink, G. Steinbeck, P. Vardas, A. Vincent, M. Walter, G. Breithardt, A. J. Camm. (2012) Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options--a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference. Europace 14:1, 8-27
CrossRef16
Reginald Liew. (2012) Almanac 2011: Cardiac arrhythmias and pacing. The national society journals present selected research that has driven recent advances in clinical cardiology. Revista Portuguesa de Cardiologia (English Edition) 31:1, 57-69
CrossRef17
Gregory Y.H. Lip. (2012) Can We Predict Stroke in Atrial Fibrillation?. Clinical Cardiology 35:S1, S21-S27
CrossRef18
P. R. Sinnaeve, M. Brueckmann, A. Clemens, J. Oldgren, J. Eikelboom, J. S. Healey. (2012) Stroke prevention in elderly patients with atrial fibrillation: challenges for anticoagulation. Journal of Internal Medicine 271:1, 15-24
CrossRef19
C. I. Coleman, D. M. Sobieraj, S. Winkler, P. Cutting, M. Mediouni, S. Alikhanov, J. Kluger. (2012) Effect of pharmacological therapies for stroke prevention on major gastrointestinal bleeding in patients with atrial fibrillation. International Journal of Clinical Practice 66:1, 53-63
CrossRef20
Chern-En Chiang, Shu Zhang, Hung Fat Tse, Wee Siong Teo, Razali Omar, Charn Sriratanasathavorn. (2012) Atrial fibrillation management in Asia: From the Asian expert forum on atrial fibrillation. International Journal of Cardiology
CrossRef21
N. Riva, S. Apostolakis, G. Y. H. Lip. (2012) Oral antithrombotic therapy and gastrointestinal bleeding: the good, the bad and the ugly. International Journal of Clinical Practice 66:1, 2-4
CrossRef22
Reginald Liew. (2012) Almanac 2011: Cardiac arrhythmias and pacing. The national society journals present selected research that has driven recent advances in clinical cardiology. Revista Portuguesa de Cardiologia 31:1, 57-69
CrossRef23
Anna Russolillo, Matteo Nicola Dario Di Minno, Antonella Tufano, Domenico Prisco, Giovanni Di Minno. (2012) Filling the gap between science & clinical practice: Prevention of stroke recurrence. Thrombosis Research 129:1, 3-8
CrossRef24
Jonas Bjerring Olesen, Gunnar Hilmar Gislason, Christian Torp-Pedersen, Gregory Y. H. Lip. (2012) Atrial Fibrillation and Vascular Disease-A Bad Combination. Clinical Cardiology 35:S1, S15-S20
CrossRef25
Craig I. Coleman, Andrew D. Straznitskas, Diana M. Sobieraj, Jeffrey Kluger, Moise W. Anglade. (2012) Cost–Effectiveness of Clopidogrel Plus Aspirin for Stroke Prevention in Patients With Atrial Fibrillation in Whom Warfarin Is Unsuitable. The American Journal of Cardiology
CrossRef26
Kyung Woo Park, Hyo-Soo Kim. (2012) Options to Overcome Clopidogrel Response Variability. Circulation Journal 76:2, 287-292
CrossRef27
Vinayak Prasad, Rachel M. Kaplan, Rod S. Passman. (2012) New Frontiers for Stroke Prevention in Atrial Fibrillation. Cerebrovascular Diseases 33:3, 199-208
CrossRef28
Songwen Chen, Jing Liu, Wenzhi Pan, Shaowen Liu, Yangang Su, Jin Bai, Wei Wang, Junbo Ge. (2012) Thromboembolic Events During the Perioperative Period in Patients Undergoing Permanent Pacemaker Implantation. Clinical Cardiologyn/a-n/a
CrossRef29
Parinaz K. Ghaswalla, Spencer E. Harpe, Patricia W. Slattum. (2012) Warfarin Use in Nursing Home Residents: Results from the 2004 National Nursing Home Survey. The American Journal of Geriatric Pharmacotherapy
CrossRef30
N. C. Pequeriaux, R. Fijnheer, E. F. Gemen, A. D. Barendrecht, F. W. Dekker, R. T. Krediet, J. J. Beutler, E. W. Boeschoten, M. Roest. (2011) Plasma concentration of von Willebrand factor predicts mortality in patients on chronic renal replacement therapy. Nephrology Dialysis Transplantation
CrossRef31
M. Moser, C. Bode. (2011) Antikoagulation bei Vorhofflimmern. Der Internist
CrossRef32
Susana P.D. Sá, Rui P. Rodrigues, João Santos-Antunes, Francisco Rocha Gonçalves, José Pedro L. Nunes. (2011) Antithrombotic therapy in nonvalvular atrial fibrillation: A narrative review. Revista Portuguesa de Cardiologia 30:12, 905-924
CrossRef33
Jonathan P. Piccini, Thomas W. Wallace, Manesh R. Patel, Richard C. Becker. (2011) Stroke Prevention in Atrial Fibrillation. Cardiovascular Drugs and Therapy 25:6, 561-570
CrossRef34
Gregory YH Lip, Hung Fat Tse, Deirdre A Lane. (2011) Atrial fibrillation. The Lancet
CrossRef35
Susana P.D. Sá, Rui P. Rodrigues, João Santos-Antunes, Francisco Rocha Gonçalves, José Pedro L. Nunes. (2011) Antithrombotic therapy in nonvalvular atrial fibrillation: A narrative review. Revista Portuguesa de Cardiologia (English Edition) 30:12, 905-924
CrossRef36
C. Patrono, F. Andreotti, H. Arnesen, L. Badimon, C. Baigent, J.-P. Collet, R. De Caterina, D. Gulba, K. Huber, S. Husted, S. D. Kristensen, J. Morais, F.-J. Neumann, L. H. Rasmussen, A. Siegbahn, P.-G. Steg, R. F. Storey, F. Van de Werf, F. Verheugt. (2011) Antiplatelet agents for the treatment and prevention of atherothrombosis. European Heart Journal 32:23, 2922-2932
CrossRef37
John C Somberg. (2011) The Impact of Comorbidities on Stroke Prophylaxis Strategies in Atrial Fibrillation Patients. American Journal of Therapeutics 18:6, 510-517
CrossRef38
Laura J. Bontempo, Eric Goralnick. (2011) Atrial Fibrillation. Emergency Medicine Clinics of North America 29:4, 747-758
CrossRef39
Tammy J. Bungard, Claudia Bucci, Heather Kertland, Kori Leblanc, Jennifer Pickering, William M. Semchuk. (2011) A systematic approach to stroke prevention for patients with atrial fibrillation. Canadian Pharmacists Journal 144:6, 287-394
CrossRef40
K SCHREIBER, O ATEKA-BARRUTIA, MA KHAMASHTA, GRV HUGHES. (2011) OBSTETRIC ANTIPHOSPHOLIPID SYNDROME - A REVIEW. Fetal and Maternal Medicine Review 22:04, 265-286
CrossRef41
Christopher Ingelmo, Oussama Wazni. (2011) Review of the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) Trial: Warfarin Versus Dabigatran. Current Cardiology Reports 13:5, 357-360
CrossRef42
Neena S. Abraham. (2011) Prescribing proton pump inhibitor and clopidogrel together. Current Opinion in Gastroenterology 27:6, 558-564
CrossRef43
Grigorios I. Leontiadis, Yuhong Yuan, Colin W. Howden. (2011) The Interaction Between Proton Pump Inhibitors and Clopidogrel and Upper Gastrointestinal Bleeding. Gastrointestinal Endoscopy Clinics of North America 21:4, 637-656
CrossRef44
José Antonio Páramo, Sara Varea, Ramón Lecumberri. (2011) Trombosis y fármacos antitrombóticos en el anciano. Medicina Clínica 137:10, 468-471
CrossRef45
Gregory M. Marcus, Melvin M. Scheinman, Edmund Keung. (2011) The Year in Clinical Cardiac Electrophysiology. Journal of the American College of Cardiology 58:16, 1645-1655
CrossRef46
K. Wasmer, L. Eckardt. (2011) Management of atrial fibrillation around the world: a comparison of current ACCF/AHA/HRS, CCS, and ESC guidelines. Europace 13:10, 1368-1374
CrossRef47
Greg Flaker, Richard Weachter. (2011) Pharmacologic Strategies for the Prevention of Stroke in Patients With Atrial Fibrillation. Current Treatment Options in Cardiovascular Medicine 13:5, 361-369
CrossRef48
Andre Lamy, Wesley Tong, Peggy Gao, Susan Chrolavicius, Amiram Gafni, Salim Yusuf, Stuart J. Connolly. (2011) The Cost of Clopidogrel Use in Atrial Fibrillation in the ACTIVE-A Trial. Canadian Journal of Cardiology
CrossRef49
David Moher, Sally Hopewell, Kenneth F. Schulz, Victor Montori, Peter C. Gøtzsche, P.J. Devereaux, Diana Elbourne, Matthias Egger, Douglas G. Altman. (2011) CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. International Journal of Surgery
CrossRef50
Isabelle Mahé, Jean-François Bergmann, Olivier Chassany, Claire Bal dit-Sollier, Guy Simoneau, Ludovic Drouet. (2011) A multicentric prospective study in usual care: D-dimer and cardiovascular events in patients with atrial fibrillation. Thrombosis Research
CrossRef51
Raffaele De Caterina, Elaine M. Hylek. (2011) Stroke Prevention in Atrial Fibrillation: Current Status and Near-Future Directions. The American Journal of Medicine 124:9, 793-799
CrossRef52
Angel Lanas, Ping Wu, Jennie Medin, Edward J. Mills. (2011) Low Doses of Acetylsalicylic Acid Increase Risk of Gastrointestinal Bleeding in a Meta-Analysis. Clinical Gastroenterology and Hepatology 9:9, 762-768.e6
CrossRef53
B. Fuentes, J. Gállego, A. Gil-Nuñez, A. Morales, F. Purroy, J. Roquer, T. Segura, J. Tejada, A. Lago, E. Díez-Tejedor, M. Alonso de Leciñana, J. Álvarez-Sabin, J. Arenillas, S. Calleja, I. Casado, M. Castellanos, J. Castillo, A. Dávalos, F. Díaz-Otero, J.A. Egido, J.C. López-Fernández, M. Freijo, A. García Pastor, F. Gilo, P. Irimia, J. Maestre, J. Masjuan, J. Martí-Fábregas, P. Martínez-Sánchez, E. Martínez-Vila, C. Molina, F. Nombela, M. Ribó, M. Rodríguez-Yañez, F. Rubio, J. Serena, P. Simal, J. Vivancos. (2011) Guía para el tratamiento preventivo del ictus isquémico y AIT (II). Recomendaciones según subtipo etiológico. Neurología
CrossRef54
Hiran C. Fernando, Michael T. Jaklitsch, Garrett L. Walsh, James E. Tisdale, Charles D. Bridges, John D. Mitchell, Joseph B. Shrager. (2011) The Society of Thoracic Surgeons Practice Guideline on the Prophylaxis and Management of Atrial Fibrillation Associated With General Thoracic Surgery: Executive Summary. The Annals of Thoracic Surgery 92:3, 1144-1152
CrossRef55
Fadi B. Nahab, Sakib Qureshi. 2011. Antithrombotics for Ischemic Stroke. , 205-222.
CrossRef56
Tariq Ahmad, Deepak Voora, Richard C. Becker. (2011) The pharmacogenetics of antiplatelet agents: towards personalized therapy?. Nature Reviews Cardiology 8:10, 560-571
CrossRef57
George Thomas, Bruce B. Lerman. (2011) Prediction of Stroke Risk in Atrial Fibrillation, Prevention of Stroke in Atrial Fibrillation, and the Impact of Long-Term Monitoring for Detecting Atrial Fibrillation. Current Atherosclerosis Reports 13:4, 290-297
CrossRef58
Mark S. Link, Derek V. Exner, Mark Anderson, Michael Ackerman, Amin Al-Ahmad, Bradley P. Knight, Steven M. Markowitz, Elizabeth S. Kaufman, David Haines, Samuel J. Asirvatham, David J. Callans, J. Paul Mounsey, Frank Bogun, Sanjiv M. Narayan, Andrew D. Krahn, Suneet Mittal, Jagmeet Singh, John D. Fisher, Sumeet S. Chugh. (2011) HRS Policy Statement: Clinical Cardiac Electrophysiology Fellowship Curriculum: Update 2011. Heart Rhythm 8:8, 1340-1356
CrossRef59
David Keeling, Trevor Baglin, Campbell Tait, Henry Watson, David Perry, Caroline Baglin, Steve Kitchen, Michael Makris, . (2011) Guidelines on oral anticoagulation with warfarin - fourth edition. British Journal of Haematology 154:3, 311-324
CrossRef60
Prakash C. Deedwania, Grace W. Huang. (2011) Role of Emerging Antithrombotic Therapy in the Prevention of Cardioembolic Complications in Patients with Atrial Fibrillation. American Journal Cardiovascular Drugs 11:4, 265-275
CrossRef61
Haralampos J. Milionis, Grigorios Gerotziafas, Michael S. Kostapanos, Anastasia Vemmou, Panagiotis Zis, Konstantinos Spengos, Moses Elisaf, Konstantinos N. Vemmos. (2011) Clopidogrel vs. Aspirin Treatment on Admission Improves 5-Year Survival After a First-ever Acute Ischemic Stroke. Data from the Athens Stroke Outcome Project. Archives of Medical Research 42:6, 443-450
CrossRef62
Gregory Y. H. Lip. (2011) The role of aspirin for stroke prevention in atrial fibrillation. Nature Reviews Cardiology 8:10, 602-606
CrossRef63
Udaya S. Tantry, Paul A. Gurbel. (2011) Assessment of oral antithrombotic therapy by platelet function testing. Nature Reviews Cardiology 8:10, 572-579
CrossRef64
Yat-Yin Lam, Terry K.W. Ma, Bryan P. Yan. (2011) Alternatives to chronic warfarin therapy for the prevention of stroke in patients with atrial fibrillation. International Journal of Cardiology 150:1, 4-11
CrossRef65
Samuel Yip, Oscar Benavente. (2011) Antiplatelet Agents for Stroke Prevention. Neurotherapeutics 8:3, 475-487
CrossRef66
Junya Aoki, Ken Uchino. (2011) Treatment of Risk Factors to Prevent Stroke. Neurotherapeutics 8:3, 463-474
CrossRef67
William David Freeman, Maria I. Aguilar. (2011) Prevention of Cardioembolic Stroke. Neurotherapeutics 8:3, 488-502
CrossRef68
Nadish Garg, Naveen Rajpurohit, Greg Flaker. (2011) Clopidogrel hydrogen sulphate for atrial fibrillation. Expert Opinion on Pharmacotherapy1-7
CrossRef69
Antonio Gutierrez, Sunil V. Rao. (2011) Atrial Fibrillation and Percutaneous Coronary Intervention: Stroke, Thrombosis, and Bleeding. Current Treatment Options in Cardiovascular Medicine 13:3, 203-214
CrossRef70
Robert G. Hart. (2011) The unmet need of patients with atrial fibrillation: AVERROES and the novel oral anticoagulants. International Journal of Stroke 6:3, 207-208
CrossRef71
Peter M Rothwell, Ale Algra, Pierre Amarenco. (2011) Medical treatment in acute and long-term secondary prevention after transient ischaemic attack and ischaemic stroke. The Lancet 377:9778, 1681-1692
CrossRef72
Hans Volkmann, M. Walter, C. Walter, S. Vetter. (2011) Antikoagulation bei Vorhofflimmern. Clinical Research in Cardiology Supplements 6:S1, 58-65
CrossRef73
Hooman Kamel, Derek R. Johnson, Manu Hegde, Alan S. Go, Stephen Sidney, Michael Sorel, Nancy K. Hills, S. Claiborne Johnston. (2011) Detection of Atrial Fibrillation After Stroke and the Risk of Recurrent Stroke. Journal of Stroke and Cerebrovascular Diseases
CrossRef74
, T. Dinh, L. H. B. Baur, R. Pisters, O. Kamp, F. W. A. Verheugt, J. L. R. M. Smeets, E. C. Cheriex, R. G. Tieleman, M. H. Prins, H. J. G. M. Crijns. (2011) Feasibility of TEE-guided stroke risk assessment in atrial fibrillation—background, aims, design and baseline data of the TIARA pilot study. Netherlands Heart Journal 19:5, 214-222
CrossRef75
Bernard J. Gersh, Jane E. Freedman, Christopher B. Granger. (2011) Tratamiento antiagregante plaquetario y anticoagulante para la prevención del ictus en pacientes con fibrilación auricular no valvular: nuevos avances basados en la evidencia. Revista Española de Cardiología 64:4, 260-268
CrossRef76
Oscar R. Benavente, Carole L. White, Lesly Pearce, Pablo Pergola, Ana Roldan, Marie-France Benavente, Christopher Coffey, Leslie A. McClure, Jeff M. Szychowski, Robin Conwit, Patricia A. Heberling, George Howard, Carlos Bazan, Gabriela Vidal-Pergola, Robert Talbert, Robert G. Hart, . (2011) The Secondary Prevention of Small Subcortical Strokes (SPS3) study. International Journal of Stroke 6:2, 164-175
CrossRef77
Larry B. Goldstein, Nada El Husseini. (2011) Neurología y cardiología: puntos de contacto. Revista Española de Cardiología 64:4, 319-327
CrossRef78
Edward L. Korn, Boris Freidlin. (2011) Inefficacy Interim Monitoring Procedures in Randomized Clinical Trials: The Need to Report. The American Journal of Bioethics 11:3, 2-10
CrossRef79
The ACTIVE I Investigators. (2011) Irbesartan in Patients with Atrial Fibrillation. New England Journal of Medicine 364:10, 928-938
Full Text80
Connolly, Stuart J., Eikelboom, John, Joyner, Campbell, Diener, Hans-Christoph, Hart, Robert, Golitsyn, Sergey, Flaker, Greg, Avezum, Alvaro, Hohnloser, Stefan H., Diaz, Rafael, Talajic, Mario, Zhu, Jun, Pais, Prem, Budaj, Andrzej, Parkhomenko, Alexander, Jansky, Petr, Commerford, Patrick, Tan, Ru San, Sim, Kui-Hian, Lewis, Basil S., Van Mieghem, Walter, Lip, Gregory Y.H., Kim, Jae Hyung, Lanas-Zanetti, Fernando, Gonzalez-Hermosillo, Antonio, Dans, Antonio L., Munawar, Muhammad, O'Donnell, Martin, Lawrence, John, Lewis, GayleAfzal, Rizwan, Yusuf, Salim, . (2011) Apixaban in Patients with Atrial Fibrillation. New England Journal of Medicine 364:9, 806-817
Full Text81
Ricarda Marinigh, Deirdre A. Lane, Gregory Y.H. Lip. (2011) Severe Renal Impairment and Stroke Prevention in Atrial Fibrillation. Journal of the American College of Cardiology 57:12, 1339-1348
CrossRef82
Hong-Guang Xie, Jian-Jun Zou, Zuo-Ying Hu, Jun-Jie Zhang, Fei Ye, Shao-Liang Chen. (2011) Individual variability in the disposition of and response to clopidogrel: Pharmacogenomics and beyond. Pharmacology & Therapeutics 129:3, 267-289
CrossRef83
Mariano A Giorgi, Hernán Cohen Arazi, Claudio D Gonzalez, Guillermo Di Girolamo. (2011) Changing anticoagulant paradigms for atrial fibrillation: dabigatran, apixaban and rivaroxaban. Expert Opinion on Pharmacotherapy 12:4, 567-577
CrossRef84
Larry B. Goldstein, Nada El Husseini. (2011) Neurology and Cardiology: Points of Contact. Revista Española de Cardiología (English Edition)
CrossRef85
Loren Laine. (2011) Proton Pump Inhibitor Co-therapy With Clopidogrel: Is There GI Benefit or Cardiovascular Harm?. Gastroenterology 140:3, 769-772.e2
CrossRef86
J.M. Calvo Romero. (2011) ¿Dabigatrán o antagonistas de la vitamina K en la prevención de ictus en pacientes con fibrilación auricular?. Revista Clínica Española 211:3, 142-146
CrossRef87
Bernard J. Gersh, Jane E. Freedman, Christopher B. Granger. (2011) Antiplatelet and Anticoagulant Therapy for Stroke Prevention in Patients With Non-valvular Atrial Fibrillation: Evidence Based Strategies and New Developments. Revista Española de Cardiología (English Edition)
CrossRef88
Simerpreet Bal, Pawan Ojha, Michael D. Hill. (2011) Stroke Prevention Treatment of Patients with Atrial Fibrillation: Old and New. Current Neurology and Neuroscience Reports 11:1, 15-27
CrossRef89
Thalia S. Field, Oscar R. Benavente. (2011) Current Status of Antiplatelet Agents to Prevent Stroke. Current Neurology and Neuroscience Reports 11:1, 6-14
CrossRef90
Gregory Y.H. Lip, Lars H. Rasmussen, S. Bertil Olsson, Sofia Zetterstrand, Christina Stahre, Anders Bylock, Maria Aunes-Jansson, Ulf Eriksson, Karin Wåhlander. (2011) Oral direct thrombin inhibitor AZD0837 for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation: A Phase II study of AZD0837 in patients who are appropriate for but unable or unwilling to take vitamin K antagonist therapy. Thrombosis Research 127:2, 91-99
CrossRef91
Matthew B. Sellers, L. Kristin Newby. (2011) Atrial fibrillation, anticoagulation, fall risk, and outcomes in elderly patients. American Heart Journal 161:2, 241-246
CrossRef92
Chiara Gentilomo, Yuan-Shung Huang, Leslie Raffini. (2011) Significant Increase in Clopidogrel Use Across U.S. Children’s Hospitals. Pediatric Cardiology 32:2, 167-175
CrossRef93
L. Samuel Wann, Anne B. Curtis, Craig T. January, Kenneth A. Ellenbogen, James E. Lowe, N.A. Mark Estes, Richard L. Page, Michael D. Ezekowitz, David J. Slotwiner, Warren M. Jackman, William G. Stevenson, Cynthia M. Tracy. (2011) 2011 ACCF/AHA/HRS Focused Update on the Management of Patients With Atrial Fibrillation (Updating the 2006 Guideline). Heart Rhythm 8:1, 157-176
CrossRef94
Melina Gattellari, Chris Goumas, Robert Aitken, John M. Worthington. (2011) Outcomes for Patients with Ischaemic Stroke and Atrial Fibrillation: The PRISM Study (A Program of Research Informing Stroke Management). Cerebrovascular Diseases 32:4, 370-382
CrossRef95
Harold P. Adams, Patricia H. Davis. 2011. Antithrombotic Therapy for Treatment of Acute Ischemic Stroke. , 971-991.
CrossRef96
David M. Greer, Shunichi Homma, Karen L. Furie. 2011. Cardiac Diseases. , 814-827.
CrossRef97
L. Samuel Wann, Anne B. Curtis, Craig T. January, Kenneth A. Ellenbogen, James E. Lowe, N.A. Mark Estes, Richard L. Page, Michael D. Ezekowitz, David J. Slotwiner, Warren M. Jackman, William G. Stevenson, Cynthia M. Tracy, Valentin Fuster, Lars E. Rydén, David S. Cannom, Jean-Yves Le Heuzey, Harry J. Crijns, James E. Lowe, Anne B. Curtis, S. Bertil Olsson, Kenneth A. Ellenbogen, Eric N. Prystowsky, Jonathan L. Halperin, Juan Luis Tamargo, G. Neal Kay, L. Samuel Wann. (2011) 2011 ACCF/AHA/HRS Focused Update on the Management of Patients With Atrial Fibrillation (Updating the 2006 Guideline). Journal of the American College of Cardiology 57:2, 223-242
CrossRef98
Mar Castellanos, Babette B. Weksler, Oscar R. Benavente. 2011. Antiplatelet Therapy for Secondary Prevention of Stroke. , 1147-1172.
CrossRef99
Carole Émile. (2011) Des nouveaux anticoagulants pour prévenir les AVC dans la fibrillation auriculaire. Option/Bio 22:447, 14
CrossRef100
Jerome L. Fleg, Wilbert S. Aronow, William H. Frishman. (2011) Cardiovascular drug therapy in the elderly: benefits and challenges. Nature Reviews Cardiology 8:1, 13-28
CrossRef101
M. Àngels Font, Jerzy Krupinski, Adrià Arboix. (2011) Antithrombotic Medication for Cardioembolic Stroke Prevention. Stroke Research and Treatment 2011, 1-23
CrossRef102
Dhara Chaudhari, Rohit Bhuriya, Rohit Arora. (2011) Newer Anticoagulants as an Alternate to Warfarin in Atrial Fibrillation: A Changing Paradigm. American Journal of Therapeutics 18:1, e1-e11
CrossRef103
Y Z Xue, L X Wang. (2010) Contemporary management of atrial fibrillation: a brief review. Advances in Medical Sciences 55:2, 130-136
CrossRef104
S. Ederhy, G. Dufaitre, C. Meuleman, E. Di Angelantonio, F. Douna, E. Berthelot, L. Boyer-Chatenet, S. Lang, N. Haddour, F. Boccara, A. Cohen. (2010) Mise au point sur la prise en charge de la FA et prévention des AVC. Annales de Cardiologie et d'Angéiologie 59, S19-S23
CrossRef105
Neena S Abraham, Mark A Hlatky, Elliott M Antman, Deepak L Bhatt, David J Bjorkman, Craig B Clark, Curt D Furberg, David A Johnson, Charles J Kahi, Loren Laine, Kenneth W Mahaffey, Eamonn M Quigley, James Scheiman, Laurence S Sperling, Gordon F Tomaselli. (2010) ACCF/ACG/AHA 2010 Expert Consensus Document on the Concomitant Use of Proton Pump Inhibitors and Thienopyridines: A Focused Update of the ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use. The American Journal of Gastroenterology 105:12, 2533-2549
CrossRef106
Nadzeya Kuzniatsova, Gregory YH Lip. (2010) New concepts and approaches to stroke prevention in the new European Society of Cardiology guidelines for the management of atrial fibrillation. Expert Review of Cardiovascular Therapy 8:12, 1643-1647
CrossRef107
M. Marcucci, A. Iorio, A. Nobili, M. Tettamanti, L. Pasina, A. Marengoni, F. Salerno, S. Corrao, P.M. Mannucci. (2010) Factors affecting adherence to guidelines for antithrombotic therapy in elderly patients with atrial fibrillation admitted to internal medicine wards. European Journal of Internal Medicine 21:6, 516-523
CrossRef108
Stefan Christian Bertog, Daniel Howard Steinberg, Nina Wunderlich, Jennifer Franke, Horst Sievert. (2010) Minimally invasive left atrial appendage ligation in an animal model. Interventional Cardiology 2:6, 773-777
CrossRef109
HJ TAN. (2010) Controversy of proton pump inhibitor and clopidogrel interaction: A review. Journal of Digestive Diseases 11:6, 334-342
CrossRef110
Neena S. Abraham, Mark A. Hlatky, Elliott M. Antman, Deepak L. Bhatt, David J. Bjorkman, Craig B. Clark, Curt D. Furberg, David A. Johnson, Charles J. Kahi, Loren Laine, Kenneth W. Mahaffey, Eamonn M. Quigley, James Scheiman, Laurence S. Sperling, Gordon F. Tomaselli. (2010) ACCF/ACG/AHA 2010 Expert Consensus Document on the Concomitant Use of Proton Pump Inhibitors and Thienopyridines: A Focused Update of the ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use. Journal of the American College of Cardiology 56:24, 2051-2066
CrossRef111
Burak Pamukcu, Deirdre A Lane, Gregory YH Lip. (2010) The assessment of stroke and bleeding risk in atrial fibrillation: where are we now?. Expert Review of Cardiovascular Therapy 8:12, 1703-1710
CrossRef112
R. Weber, B. Frank, H.-C. Diener. (2010) Antithrombotische und Antikoagulanzientherapie nach Schlaganfall und transitorisch ischämischer Attacke. Der Nervenarzt 81:12, 1509-1519
CrossRef113
H. S. Kirshner. (2010) Current issues in antiplatelet therapy for stroke prevention: the importance of stroke subtypes and differences between stroke and MI patients. Journal of Neurology 257:11, 1788-1797
CrossRef114
Hans-Christoph Diener, Christian Weimar, Ralph Weber. (2010) Antiplatelet therapy in secondary stroke prevention - state of the art. Journal of Cellular and Molecular Medicine 14:11, 2552-2560
CrossRef115
Jonathan Mant, Duncan Edwards. (2010) Stroke Prevention in Atrial Fibrillation. Drugs & Aging 27:11, 859-870
CrossRef116
Paré, Guillaume, Mehta, Shamir R., Yusuf, Salim, Anand, Sonia S., Connolly, Stuart J., Hirsh, Jack, Simonsen, Katy, Bhatt, Deepak L., Fox, Keith A.A., Eikelboom, John W., . (2010) Effects of CYP2C19 Genotype on Outcomes of Clopidogrel Treatment. New England Journal of Medicine 363:18, 1704-1714
Full Text117
, , , A. J. Camm, P. Kirchhof, G. Y. H. Lip, U. Schotten, I. Savelieva, S. Ernst, I. C. Van Gelder, N. Al-Attar, G. Hindricks, B. Prendergast, H. Heidbuchel, O. Alfieri, A. Angelini, D. Atar, P. Colonna, R. De Caterina, J. De Sutter, A. Goette, B. Gorenek, M. Heldal, S. H. Hohloser, P. Kolh, J.-Y. Le Heuzey, P. Ponikowski, F. H. Rutten, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. E. Vardas, V. Agladze, E. Aliot, T. Balabanski, C. Blomstrom-Lundqvist, A. Capucci, H. Crijns, B. Dahlof, T. Folliguet, M. Glikson, M. Goethals, D. C. Gulba, S. Y. Ho, R. J. M. Klautz, S. Kose, J. McMurray, P. Perrone Filardi, P. Raatikainen, M. J. Salvador, M. J. Schalij, A. Shpektor, J. Sousa, J. Stepinska, H. Uuetoa, J. L. Zamorano, I. Zupan. (2010) Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal 31:19, 2369-2429
CrossRef118
, , , A. J. Camm, P. Kirchhof, G. Y. H. Lip, U. Schotten, I. Savelieva, S. Ernst, I. C. Van Gelder, N. Al-Attar, G. Hindricks, B. Prendergast, H. Heidbuchel, O. Alfieri, A. Angelini, D. Atar, P. Colonna, R. De Caterina, J. De Sutter, A. Goette, B. Gorenek, M. Heldal, S. H. Hohloser, P. Kolh, J.-Y. Le Heuzey, P. Ponikowski, F. H. Rutten, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. E. Vardas, V. Agladze, E. Aliot, T. Balabanski, C. Blomstrom-Lundqvist, A. Capucci, H. Crijns, B. Dahlof, T. Folliguet, M. Glikson, M. Goethals, D. C. Gulba, S. Y. Ho, R. J. M. Klautz, S. Kose, J. McMurray, P. Perrone Filardi, P. Raatikainen, M. J. Salvador, M. J. Schalij, A. Shpektor, J. Sousa, J. Stepinska, H. Uuetoa, J. L. Zamorano, I. Zupan. (2010) Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 12:10, 1360-1420
CrossRef119
W. Fischbach, H. Darius, M. Gross, H. Koop, I. Kruck, K.U. Petersen. (2010) Gleichzeitige Anwendung von Thrombozytenaggregationshemmern und Protonenpumpeninhibitoren (PPIs). Der Kardiologe 4:5, 353-364
CrossRef120
Arnold Pinter, Paul Dorian. (2010) REVIEW: New Approaches to Atrial Fibrillation Management: Treat the Patient, not the ECG. Cardiovascular Therapeutics 28:5, 302-310
CrossRef121
Jeffrey J. Siracuse, Michael P. Robich, Shiva Gautam, Ekkehard M. Kasper, Donald W. Moorman, Carl J. Hauser. (2010) Antiplatelet agents, warfarin, and epidemic intracranial hemorrhage. Surgery 148:4, 724-730
CrossRef122
Ralph Weber, Hans-Christoph Diener, Christian Weimar. (2010) Prevention of cardioembolic stroke in patients with atrial fibrillation. Expert Review of Cardiovascular Therapy 8:10, 1405-1415
CrossRef123
Guillermo Ruiz-Irastorza, Mark Crowther, Ware Branch, Munther A Khamashta. (2010) Antiphospholipid syndrome. The Lancet 376:9751, 1498-1509
CrossRef124
Luke R.E. Bereznicki, Gregory M. Peterson. (2010) REVIEW: New Antithrombotics for Atrial Fibrillation. Cardiovascular Therapeutics 28:5, 278-286
CrossRef125
P. Aguiar-Souto, S. Raposeiras-Roubín, J.R. González-Juanatey. (2010) Novedades en el último año en el planteamiento terapéutico de la cardiopatía hipertensiva, de la cardiopatía isquémica y de la fibrilación auricular. Revista Clínica Española 210, 2-11
CrossRef126
Scott R. Willoughby, Ross L. Roberts-Thomson, Han S. Lim, Carlee Schultz, Anisha Prabhu, Paolo De Sciscio, Christopher X. Wong, Matthew I. Worthley, Prashanthan Sanders. (2010) Atrial platelet reactivity in patients with atrial fibrillation. Heart Rhythm 7:9, 1178-1183
CrossRef127
Inder M. Singh, David R. Holmes. (2010) Left Atrial Appendage Closure. Current Cardiology Reports 12:5, 413-421
CrossRef128
Andrew J. Krainik, Jane Chen. (2010) Atrial Fibrillation in the Elderly. Current Cardiovascular Risk Reports 4:5, 354-360
CrossRef129
A. Gil Núñez. (2010) Avances en la prevención de la isquemia cerebral por fibrilación auricular. Neurología 25:7, 401-408
CrossRef130
Ricarda Marinigh, Gregory Y.H. Lip, Nicola Fiotti, Carlo Giansante, Deirdre A. Lane. (2010) Age as a Risk Factor for Stroke in Atrial Fibrillation Patients. Journal of the American College of Cardiology 56:11, 827-837
CrossRef131
D Moher. (2010) CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials (Chinese version). Journal of Chinese Integrative Medicine701-741
CrossRef132
William D Freeman, Maria Aguilar. (2010) Anticoagulation therapy for cardioembolic stroke prevention in the elderly: defining benefits and risks. Aging Health 6:4, 439-450
CrossRef133
David Moher, Sally Hopewell, Kenneth F. Schulz, Victor Montori, Peter C. Gøtzsche, P.J. Devereaux, Diana Elbourne, Matthias Egger, Douglas G. Altman. (2010) CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. Journal of Clinical Epidemiology 63:8, e1-e37
CrossRef134
Stéphane Ederhy, Ghislaine Dufaitre, Louise Boyer-Chatenet, Catherine Meuleman, Emanuele Di Angelantonio, Sylvie Lang, Franck Boccara, Ariel Cohen. (2010) Should all patients with non-valvular atrial fibrillation be anticoagulated?. International Journal of Cardiology 143:1, 8-15
CrossRef135
Gregory M. Marcus, Melvin M. Scheinman, Edmund Keung. (2010) The Year in Clinical Cardiac Electrophysiology. Journal of the American College of Cardiology 56:8, 667-676
CrossRef136
James D. Marsh, Salah G. Keyrouz. (2010) Stroke Prevention and Treatment. Journal of the American College of Cardiology 56:9, 683-691
CrossRef137
M. Stramba-Badiale. (2010) Women and research on cardiovascular diseases in Europe: a report from the European Heart Health Strategy (EuroHeart) project. European Heart Journal 31:14, 1677-1681
CrossRef138
Hermelinda G. Abcede, Bruce Ovbiagele. (2010) Update on Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation. Current Treatment Options in Cardiovascular Medicine 12:3, 250-260
CrossRef139
G. Y. H. Lip, K. Huber, F. Andreotti, H. Arnesen, J. K. Airaksinen, T. Cuisset, P. Kirchhof, F. Marin. (2010) Antithrombotic management of atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing coronary stenting: executive summary--a Consensus Document of the European Society of Cardiology Working Group on Thrombosis, endorsed by the European Heart Rhythm Association (EHRA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European Heart Journal 31:11, 1311-1318
CrossRef140
O. Lomas, R. A. Argyle, B. D. Prendergast. (2010) Will direct thrombin inhibition change the boundaries of oral anti-coagulation?. QJM 103:6, 429-434
CrossRef141
Carlos G. Santos-Gallego, Jeremías Bayón, Juan José Badimón. (2010) Thrombi of Different Pathologies: Implications for Diagnosis and Treatment. Current Treatment Options in Cardiovascular Medicine 12:3, 274-291
CrossRef142
SL Keir, K Strachan. (2010) Stroke medicine for the geriatrician 2010. Reviews in Clinical Gerontology 20:02, 92-104
CrossRef143
Renato D. Lopes, David Garcia, Richard C. Becker, Christopher B. Granger, L. Kristin Newby, John H. Alexander, E. Marc Jolicoeur, Allison Handler, Karen S. Pieper, Antonio C. Carvalho, Helio P. Guimaraes, Dalton A. F. Chamone, Antonio C. Baruzzi, Fabio S. Machado, Ari Timerman, Antonio C. Lopes. (2010) Highlights from the II international symposium of thrombosis and anticoagulation (ISTA), October 22–23, 2009, São Paulo, Brazil. Journal of Thrombosis and Thrombolysis 29:4, 395-408
CrossRef144
Britta Weidtmann, Thomas Demming, Hendrik Bonnemeier. (2010) The burden of atrial fibrillation. Clinical Research in Cardiology Supplements 5:S1, 57-62
CrossRef145
NEIL GUPTA, RAHUL NAYAK, SCOTT W. GRISOLANO, DANIEL C. BUCKLES, PETER N. TADROS. (2010) Defining Patients at High Risk for Gastrointestinal Hemorrhage after Drug-Eluting Stent Placement: A Cost Utility Analysis. Journal of Interventional Cardiology 23:2, 179-187
CrossRef146
Peter R. Kowey, James A. Reiffel, Robert Myerburg, Gerald V. Naccarelli, Douglas L. Packer, Craig M. Pratt, Michael J. Reiter, Albert L. Waldo. (2010) Warfarin and Aspirin Use in Atrial Fibrillation Among Practicing Cardiologist (from the AFFECTS Registry). The American Journal of Cardiology 105:8, 1130-1134
CrossRef147
Brian Olshansky, Mario Delmar, Gordon F. Tomaselli. (2010) The year in arrhythmias—2009: Part I. Heart Rhythm 7:3, 417-426
CrossRef148
David Singh, Steven Singh. (2010) Emerging drugs for atrial fibrillation. Therapy 7:2, 125-132
CrossRef149
Laurent Fauchier, Laurent Gorin, Dominique Babuty. (2010) How should we treat patients with atrial fibrillation and a CHADS 2 score of 1?. Therapy 7:2, 111-115
CrossRef150
Freek W. A. Verheugt. (2010) Novel oral anticoagulants to prevent stroke in atrial fibrillation. Nature Reviews Cardiology 7:3, 149-154
CrossRef151
John W. Eikelboom, Martin O'Donnell, Salim Yusuf, Rafael Diaz, Greg Flaker, Robert Hart, Stefan Hohnloser, Campbell Joyner, Jack Lawrence, Prem Pais, Janice Pogue, David Synhorst, Stuart J. Connolly. (2010) Rationale and design of AVERROES: Apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment. American Heart Journal 159:3, 348-353.e1
CrossRef152
Renee M Sullivan, Brian Olshansky. (2010) Managing thromboembolic risk in patients with atrial fibrillation: are we approaching a new frontier?. Therapy 7:2, 107-110
CrossRef153
Graeme J Hankey, John W Eikelboom. (2010) Antithrombotic drugs for patients with ischaemic stroke and transient ischaemic attack to prevent recurrent major vascular events. The Lancet Neurology 9:3, 273-284
CrossRef154
Graeme J Hankey. (2010) Replacing aspirin and warfarin for secondary stroke prevention: is it worth the costs?. Current Opinion in Neurology 23:1, 65-72
CrossRef155
Roger E. Kelley. (2010) Neurologic Presentations of Cardiac Disease. Neurologic Clinics 28:1, 17-36
CrossRef156
Carlo Patrono, Bianca Rocca. (2010) The Future of Antiplatelet Therapy in Cardiovascular Disease. Annual Review of Medicine 61:1, 49-61
CrossRef157
Carl J. Pepine. (2010) Residual risk for secondary ischemic events in patients with atherothrombotic disease: Opportunity for future improvements in patient care. Annals of Medicine 42:1, 19-35
CrossRef158
Anthony S. Wierzbicki, Adie Viljoen. (2010) Hyperlipidaemia in Paediatric Patients. Drug Safety 33:2, 115-125
CrossRef159
Clotilde Balucani, Kristian Barlinn, Zeljko Zivanovic, Lucilla Parnetti, Mauro Silvestrini, Andrei V. Alexandrov. (2010) Dual Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke: A Ghost from the Past or a New Frontier?. Stroke Research and Treatment 2010, 1-8
CrossRef160
Richard A. Bernstein, Rod Passman. (2010) Prevention of Stroke in Patients with High-Risk Atrial Fibrillation. Current Neurology and Neuroscience Reports 10:1, 34-39
CrossRef161
Jens Seiler, William G. Stevenson. (2010) Atrial Fibrillation in Congestive Heart Failure. Cardiology in Review 18:1, 38-50
CrossRef162
A. Gil Núñez. (2010) Advances in the Prevention of Cerebral Ischaemia Due to Atrial Fibrillation. Neurología (English Edition) 25:7, 401-408
CrossRef163
Gregory W Albers. (2010) Stroke: more protection for patients with atrial fibrillation. The Lancet Neurology 9:1, 2-4
CrossRef164
Sarah A. Spinler. (2010) Atrial fibrillation: A promising new anticoagulant for stroke prevention. Nature Reviews Cardiology 7:1, 10-11
CrossRef165
Miguel Á. Arias, Marta Pachón, Alberto Puchol, Eduardo Castellanos. (2010) Electrofisiología cardiaca y arritmias. Revista Española de Cardiología 63, 61-72
CrossRef166
Loren Laine, Charles Hennekens. (2010) Proton Pump Inhibitor and Clopidogrel Interaction: Fact or Fiction?. The American Journal of Gastroenterology 105:1, 34-41
CrossRef167
Kurt M Reinhart, C. Michael White, William L Baker. (2009) Prasugrel: A Critical Comparison with Clopidogrel. Pharmacotherapy 29:12, 1441-1451
CrossRef168
L. Guédon-Moreau, S. Kacet. (2009) Les enjeux du traitement antithrombotique. Annales de Cardiologie et d'Angéiologie 58, S25-S30
CrossRef169
David Fitchett, John Eikelboom, Stephen Fremes, David Mazer, Steve Singh, Bindu Bittira, Stephanie Brister, John J. Graham, Milan Gupta, Keyvan Karkouti, Agnes Lee, Michael Love, Rod McArthur, Mark Peterson, Subodh Verma, Terrence M. Yau. (2009) Dual antiplatelet therapy in patients requiring urgent coronary artery bypass grafting surgery: A position statement of the Canadian Cardiovascular Society. Canadian Journal of Cardiology 25:12, 683-689
CrossRef170
Luciana Armaganijan, John Eikelboom, Jeff S. Healey, Carlos A. Morillo. (2009) New pharmacotherapy for stroke prevention in atrial fibrillation: Update 2010. Advances in Therapy 26:12, 1058-1071
CrossRef171
J.-Y. Le Heuzey. (2009) Enjeux du futur. Nouveaux médicaments antithrombotiques. Annales de Cardiologie et d'Angéiologie 58, S64-S66
CrossRef172
J. G.F. Cleland, A. P. Coletta, A. Yassin, L. Buga, A. Torabi, A. L. Clark. (2009) Clinical trials update from the European Society of Cardiology Meeting 2009: AAA, RELY, PROTECT, ACTIVE-I, European CRT survey, German pre-SCD II registry, and MADIT-CRT. European Journal of Heart Failure 11:12, 1214-1219
CrossRef173
A. J. Camm. (2009) The RE-LY study: Randomized Evaluation of Long-term anticoagulant therapY: dabigatran vs. warfarin. European Heart Journal 30:21, 2554-2555
CrossRef174
Nerses Sanossian, Bruce Ovbiagele. (2009) Prevention and management of stroke in very elderly patients. The Lancet Neurology 8:11, 1031-1041
CrossRef175
D. Sander, T. Etgen. (2009) Sekundärprophylaxe des Schlaganfalls nach PRoFESS und SPARCL. Der Internist 50:11, 1227-1238
CrossRef176
Joachim R. Ehrlich, Stefan H. Hohnloser. (2009) Milestones in the management of atrial fibrillation. Heart Rhythm 6:11, S62-S67
CrossRef177
Pieter De Meester, Vincent Thijs, Rik Willems, Werner Budts. (2009) Percutaneous closure of the left atrial appendage in atrial fibrillation: an alternative if standard treatment fails?. Interventional Cardiology 1:1, 119-131
CrossRef178
Christian Weimar, Ralph Weber, Hans-Christoph Diener. (2009) Antithrombotic medication for stroke prevention. Expert Review of Cardiovascular Therapy 7:10, 1245-1254
CrossRef179
(2009) Clopidogrel plus Aspirin in Atrial Fibrillation. New England Journal of Medicine 361:13, 1312-1315
Full Text180
Connolly, Stuart J., Ezekowitz, Michael D., Yusuf, Salim, Eikelboom, John, Oldgren, Jonas, Parekh, Amit, Pogue, Janice, Reilly, Paul A., Themeles, Ellison, Varrone, Jeanne, Wang, Susan, Alings, Marco, Xavier, Denis, Zhu, Jun, Diaz, Rafael, Lewis, Basil S., Darius, Harald, Diener, Hans-Christoph, Joyner, Campbell D., Wallentin, Lars, the RE-LY Steering Committee and Investigators. (2009) Dabigatran versus Warfarin in Patients with Atrial Fibrillation. New England Journal of Medicine 361:12, 1139-1151
Full Text181
Rieke van der Graaf, Johannes JM van Delden. (2009) Conflating Scientific With Clinical Considerations. The American Journal of Bioethics 9:9, 58-59
CrossRef182
B. Giannakopoulos, S. A. Krilis. (2009) How I treat the antiphospholipid syndrome. Blood 114:10, 2020-2030
CrossRef183
Niall JJ MacDougall, Sanjay Amarasinghe, Keith W Muir. (2009) Secondary prevention of stroke. Expert Review of Cardiovascular Therapy 7:9, 1103-1115
CrossRef184
Gregory Y.H. Lip, Deirdre A. Lane. (2009) Tratamiento anticoagulante y antiagregante plaquetario combinado en pacientes con fibrilación auricular. Revista Española de Cardiología 62:9, 972-975
CrossRef185
Philip R. Liebson. (2009) ACTIVE A and AURORA. Preventive Cardiology 12:4, 205-208
CrossRef186
Frederic S. Resnic, Akshay Desai. (2009) Highlights from the 58th Annual Scientific Sessions of the American College of Cardiology, March 28 to 31, 2009, Orlando, Florida. The Journal of Thoracic and Cardiovascular Surgery 138:3, 795-797
CrossRef187
Freek WA Verheugt. (2009) Who is ineligible for warfarin in atrial fibrillation?. The Lancet 374:9689, 510-511
CrossRef188
Bharat K Kantharia, Arti N Shah. (2009) Combination of clopidogrel and aspirin for reduction of vascular events in patients with atrial fibrillation. Expert Review of Cardiovascular Therapy 7:7, 749-753
CrossRef189
J. G.F. Cleland, A. P. Coletta, A. L. Clark, D. Cullington. (2009) Clinical trials update from the American College of Cardiology 2009: ADMIRE-HF, PRIMA, STICH, REVERSE, IRIS, partial ventricular support, FIX-HF-5, vagal stimulation, REVIVAL-3, pre-RELAX-AHF, ACTIVE-A, HF-ACTION, JUPITER, AURORA, and OMEGA. European Journal of Heart Failure 11:6, 622-630
CrossRef190
Go, Alan S., . (2009) The ACTIVE Pursuit of Stroke Prevention in Patients with Atrial Fibrillation. New England Journal of Medicine 360:20, 2127-2129
Full Text
- Letters
