Secondary prevention of stroke in atrial fibrillation, use of apixaban: ARISTOTLE, AVERROES studies
Abstract
Ischemic stroke (IS) prevention in non-valvular atrial fibrillation (NVAF) patients who already had IS or Transient Ischemic Attack (TIA) is the actual problem of up-to-date neurology. The article analyses methods of IS secondary prevention in AF, particularly usage of vitamin Kantagonist – warfarin and new oral anticoagulants: inhibitors of Xa factor (apixaban, rivaroxaban) and direct thrombin inhibiror – dabigatran.
Presented results ARISTOTLE study, where have defined preference apixaban vs warfarin, and AVEEROES study, where have shown preference apixaban vs ASA in AF patients. It was noted that apixaban demonstrated superiority vs warfarin in all of the 3 key outcomes:stroke/systemic embolism prevention, including recurrent, major bleeding reducing, reduction in all-cause mortality. Optimization of secondary stroke prevention in AF patients can lead to substantial reduction of morbidity and mortality in our country.
About the Authors
V.A. Parfenov
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia,
11, Rossolimo St., Moscow 119021
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery and A.Ya. Kozhevnikov Clinic of Nervous System Diseases
S.V. Verbitskaya
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia,
11, Rossolimo St., Moscow 119021
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery and A.Ya. Kozhevnikov Clinic of Nervous System Diseases
References
1. Скворцова ВИ, Губский ЛВ, Стаховская ЛВ и др. Ишемический инсульт. В кн.: Неврология. Национальное руководство. Под редакцией Е.И. Гусева, А.И. Коновалова, В.И. Скворцовой. Москва: ГЭОТАР-МЕДИА; 2009, С. 592–615. [Skvortsova VI, Gubskii LV, Stakhovskaya LV, et al. Ischemic stroke. In: Nevrologiya, natsional'noe rukovodstvo [Neurology. National Guide]. Guseva EI, Konovalova AI, Skvortsovoi VI, editors. Moscow: GEOTAR-MEDIA; 2009, P. 592–615.
2. Суслина ЗА, Фонякин АВ, Гераскина ЛА и др. Практическая кардионеврология. Москва: ИМА-ПРЕСС; 2010. 304 с. [Suslina ZA, Fonyakin AV, Geraskina LA, et al. Prakticheskaya kardionevrologiya [Practical cardioneurology]. Moscow: IMA-PRESS; 2010. 304 p.]
3. Парфенов ВА, Хасанова ДР. Ишемический инсульт. Москва: МИА; 2012. 288 с. [Parfenov VA, Khasanova DR. Ishemicheskii insul't [Ischemic stroke]. Moscow: MIA; 2012. 288 p.]
4. Sacco RL, Adams R, Albers G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic
5. attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006;37(2):577–617. DOI: http://dx.doi.org/10.1161/01.STR.0000199147.30016.74.
6. European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc Dis. 2008;25(5):457–507. DOI: 10.1159/000131083. Epub 2008 May 6.
7. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic
8. Attack A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011;42(1):227–76. DOI: 10.1161/STR.0b013e3181f7d043. Epub 2010 Oct 21.
9. Диагностика и лечение фибрилляции предсердий. Рекомендации РКО, ВНОА и АССХ. Москва; 2012. 112 с. [Diagnostika i lechenie fibrillyatsii predserdii. Rekomendatsii RKO, VNOA i ASSKh [Diagnostics and treatment of fibrillation of auricles. PKO, BHOA and ACCX recommendations]. Moscow; 2012. 112 p.]
10. Hart RG, Pearce LA, Aguilar MI. Metaanalysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146(12):857–67. DOI:http://dx.doi.org/10.7326/0003-4819-146-12-200706190-00007.
11. Connolly S, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51. DOI:10.1056/NEJMoa0905561. Epub 2009 Aug 30.
12. Patel МR, Mahaffey KW, Garg J, et al. Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation. N Engl J Med. 2011;365(10):883–91. DOI:10.1056/NEJMoa1009638. Epub 2011 Aug 10.
13. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2011;365(11):981–92. DOI: 10.1056/NEJMoa1107039. Epub 2011 Aug 27.
14. Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med. 2013;369(22):2093–104. DOI: 10.1056/NEJMoa1310907. Epub 2013 Nov 19.
15. Connolly SJ, Eikelboom J, Joyneret C, et al; AVERROES Steering Committee and Investigators. Apixaban in patients with atrial
16. fibrillation. КN Engl J Med. 2011;364(9):806–17. DOI:10.1056/NEJMoa1007432. Epub 2011 Feb 10.
17. Вербицкая СВ, Парфенов ВА. Вторичная профилактика инсульта в амбулаторных условиях. Неврологический журнал. 2011;16(1):42–6. [Verbitskaya SV, Parfenov VA. The secondary prevention of stroke in outpatient conditions. Nevrologicheskii zhurnal. 2011;16(1):42–6. (In Russ.)]
18. Шандалин ВА, Фонякин АВ, Гераскина ЛА. Вторичная профилактика ишемического инсульта: от рекомендаций – к реальной клинической практике. Неврология, нейропсихиатрия, психосоматика. 2012;(2):35–41. [Shandalin VA, Fonyakin AV, Geraskina LA. Secondary prevention of ischemic stroke: from recommendations to real clinical practice. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(2):35–41. (In Russ.)]. DOI: http://dx.doi.org/10.14412/2074-2711-2012-379.
19. Heidbuchel H, Verhamme P, Alings M, et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013;15(5):625–51. DOI: 10.1093/europace/eut083.
20. Lip GYH, Larsen TB, Skjoth F, Rasmussen LH. Indirect comparisons of new oral anticoagulant drugs for efcacy and safety when used for stroke prevention in atrial brillation. J Am Coll Cardiol 2012;60:738 –746. Doi: 10.1016/j.jacc.2012.03.019.
21. Potpara TS, Polovina MM, Licina MM, et al. Novel oral anticoagulants for stroke prevention in atrial fibrillation: focus on apixaban. Adv Ther. 2012 Jun;29(6):491–507. Doi: 10.1007/s12325-012-0026-8.
Review
For citations:
Parfenov V., Verbitskaya S. Secondary prevention of stroke in atrial fibrillation, use of apixaban: ARISTOTLE, AVERROES studies. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(2S):7-14. (In Russ.) https://doi.org/10.14412/2074-2711-2014-2S-7-14
Views: 885
Email this article 