This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral ste...This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral stenosis. Warfarin was more effective than aspirin in preventing stroke in these patients; combined therapy with low anticoagulant intensity was ineffective. Mitral stenosis patients were not investigated. We performed a multicenter randomized trial in 1,209 patients at risk. The intermediate-risk group included patients with risk factors or age >60 years: 242 received the cyclooxygenase inhibitor triflusal, 237 received acenocumarol, and 235 received a combination of both. The high-risk group included patients with prior embolism or mitral stenosis: 259 received anticoagulants and 236 received the combined therapy. Median follow-up was 2.76 years. Primary outcome was a composite of vascular death and nonfatal stroke or systemic embolism. Primary outcome was lower in the combined therapy than in the anticoagulant arm in both the intermediate-(hazard ratio0.33 [95%confidence interval(CI)0.12 to 0.91]; p=0.02) and the high-risk group(HR 0.51[95%CI 0.27 to 0.96]; p=0.03). Primary outcome plus severe bleeding was lower with combined therapy in the intermediate-risk group. Nonvalvular and mitral stenosis patients had similar embolic event rates during anticoagulant therapy. The combined antiplatelet plus moderate-intensity anticoagulation therapy significantly decreased the vascular events compared with anticoagulation alone and proved to be safe in atrial fibrillation patients.展开更多
EMPA-REG OUTCOME研究结果于9月17日在第51届欧洲糖尿病研究学会年会上公布并同时发表在New England Journal of Medicine杂志。结果表明,治疗心血管事件风险较高的2型糖尿病患者时,标准治疗方案基础上追加勃林格殷格翰和礼来公司的Jard...EMPA-REG OUTCOME研究结果于9月17日在第51届欧洲糖尿病研究学会年会上公布并同时发表在New England Journal of Medicine杂志。结果表明,治疗心血管事件风险较高的2型糖尿病患者时,标准治疗方案基础上追加勃林格殷格翰和礼来公司的Jardiance®(恩格列净)显著降低由心血管死亡、非致死性心梗、非致死性脑卒中组成的复合终点的风险达14%。其中心血管死亡降低38%,非致死性心梗、展开更多
文摘This trial evaluated the efficacy and safety of the combination of antiplatelet and moderate-intensity anticoagulation therapy in patients with atrial fibrillation associated with recognized risk factors or mitral stenosis. Warfarin was more effective than aspirin in preventing stroke in these patients; combined therapy with low anticoagulant intensity was ineffective. Mitral stenosis patients were not investigated. We performed a multicenter randomized trial in 1,209 patients at risk. The intermediate-risk group included patients with risk factors or age >60 years: 242 received the cyclooxygenase inhibitor triflusal, 237 received acenocumarol, and 235 received a combination of both. The high-risk group included patients with prior embolism or mitral stenosis: 259 received anticoagulants and 236 received the combined therapy. Median follow-up was 2.76 years. Primary outcome was a composite of vascular death and nonfatal stroke or systemic embolism. Primary outcome was lower in the combined therapy than in the anticoagulant arm in both the intermediate-(hazard ratio0.33 [95%confidence interval(CI)0.12 to 0.91]; p=0.02) and the high-risk group(HR 0.51[95%CI 0.27 to 0.96]; p=0.03). Primary outcome plus severe bleeding was lower with combined therapy in the intermediate-risk group. Nonvalvular and mitral stenosis patients had similar embolic event rates during anticoagulant therapy. The combined antiplatelet plus moderate-intensity anticoagulation therapy significantly decreased the vascular events compared with anticoagulation alone and proved to be safe in atrial fibrillation patients.
文摘EMPA-REG OUTCOME研究结果于9月17日在第51届欧洲糖尿病研究学会年会上公布并同时发表在New England Journal of Medicine杂志。结果表明,治疗心血管事件风险较高的2型糖尿病患者时,标准治疗方案基础上追加勃林格殷格翰和礼来公司的Jardiance®(恩格列净)显著降低由心血管死亡、非致死性心梗、非致死性脑卒中组成的复合终点的风险达14%。其中心血管死亡降低38%,非致死性心梗、
