Cited 69 times in
Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation-Related Mild Ischemic Stroke: A Randomized Clinical Trial
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 김영대 | - |
dc.date.accessioned | 2020-07-16T16:48:54Z | - |
dc.date.available | 2020-07-16T16:48:54Z | - |
dc.date.issued | 2017-10 | - |
dc.identifier.issn | 2168-6149 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/178329 | - |
dc.description.abstract | Importance: In atrial fibrillation (AF)-related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective: To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, setting, and participants: A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation. Analysis was performed on a modified intent-to-treat basis. Interventions: Participants were randomized 1:1 to receive rivaroxaban, 10 mg/d for 5 days followed by 15 or 20 mg/d, or warfarin with a target international normalized ratio of 2.0-3.0, for 4 weeks. Main outcomes and measures: The primary end point was the composite of new ischemic lesion or new intracranial hemorrhage seen on results of magnetic resonance imaging at 4 weeks. Primary analysis was performed in patients who received at least 1 dose of study medications and completed follow-up magnetic resonance imaging. Key secondary end points were individual components of the primary end point and hospitalization length. Results: Of 195 patients randomized, 183 individuals (76 women and 107 men; mean [SD] age, 70.4 [10.4] years) completed magnetic resonance imaging follow-up and were included in the primary end point analysis. The rivaroxaban group (n = 95) and warfarin group (n = 88) showed no differences in the primary end point (47 [49.5%] vs 48 [54.5%]; relative risk, 0.91; 95% CI, 0.69-1.20; P = .49) or its individual components (new ischemic lesion: 28 [29.5%] vs 31 of 87 [35.6%]; relative risk, 0.83; 95% CI, 0.54-1.26; P = .38; new intracranial hemorrhage: 30 [31.6%] vs 25 of 87 [28.7%]; relative risk, 1.10; 95% CI, 0.70-1.71; P = .68). Each group had 1 clinical ischemic stroke, and all new intracranial hemorrhages were asymptomatic hemorrhagic transformations. Hospitalization length was reduced with rivaroxaban compared with warfarin (median, 4.0 days [interquartile range, 2.0-6.0 days] vs 6.0 days [interquartile range, 4.0-8.0]; P < .001). Conclusions and relevance: In mild AF-related acute ischemic stroke, rivaroxaban and warfarin had comparable safety and efficacy. Trial registration: clinicaltrials.gov Identifier: NCT02042534. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | American Medical Association | - |
dc.relation.isPartOf | JAMA NEUROLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Aged, 80 and over | - |
dc.subject.MESH | Anticoagulants / therapeutic use* | - |
dc.subject.MESH | Atrial Fibrillation / complications | - |
dc.subject.MESH | Atrial Fibrillation / diagnostic imaging | - |
dc.subject.MESH | Atrial Fibrillation / drug therapy* | - |
dc.subject.MESH | Diffusion Magnetic Resonance Imaging | - |
dc.subject.MESH | Factor Xa Inhibitors / therapeutic use* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Follow-Up Studies | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Intracranial Hemorrhages / etiology | - |
dc.subject.MESH | Magnetic Resonance Angiography | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Republic of Korea | - |
dc.subject.MESH | Rivaroxaban / therapeutic use* | - |
dc.subject.MESH | Stroke / complications | - |
dc.subject.MESH | Stroke / diagnostic imaging | - |
dc.subject.MESH | Stroke / drug therapy* | - |
dc.subject.MESH | Treatment Outcome | - |
dc.subject.MESH | Warfarin / therapeutic use* | - |
dc.title | Rivaroxaban vs Warfarin Sodium in the Ultra-Early Period After Atrial Fibrillation-Related Mild Ischemic Stroke: A Randomized Clinical Trial | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Neurology (신경과학교실) | - |
dc.contributor.googleauthor | Keun-Sik Hong | - |
dc.contributor.googleauthor | Sun U Kwon | - |
dc.contributor.googleauthor | Sang Hun Lee | - |
dc.contributor.googleauthor | Ji Sung Lee | - |
dc.contributor.googleauthor | Yong-Jae Kim | - |
dc.contributor.googleauthor | Tae-Jin Song | - |
dc.contributor.googleauthor | Young Dae Kim | - |
dc.contributor.googleauthor | Man-Seok Park | - |
dc.contributor.googleauthor | Eung-Gyu Kim | - |
dc.contributor.googleauthor | Jae-Kwan Cha | - |
dc.contributor.googleauthor | Sang Min Sung | - |
dc.contributor.googleauthor | Byung-Woo Yoon | - |
dc.contributor.googleauthor | Oh Young Bang | - |
dc.contributor.googleauthor | Woo-Keun Seo | - |
dc.contributor.googleauthor | Yang-Ha Hwang | - |
dc.contributor.googleauthor | Seong Hwan Ahn | - |
dc.contributor.googleauthor | Dong-Wha Kang | - |
dc.contributor.googleauthor | Hyun Goo Kang | - |
dc.contributor.googleauthor | Kyung-Ho Yu | - |
dc.identifier.doi | 10.1001/jamaneurol.2017.2161 | - |
dc.contributor.localId | A00702 | - |
dc.relation.journalcode | J01199 | - |
dc.identifier.eissn | 2168-6157 | - |
dc.identifier.pmid | 28892526 | - |
dc.identifier.url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710243/?report=printable | - |
dc.contributor.alternativeName | Kim, Young Dae | - |
dc.contributor.affiliatedAuthor | 김영대 | - |
dc.citation.volume | 74 | - |
dc.citation.number | 10 | - |
dc.citation.startPage | 1206 | - |
dc.citation.endPage | 1215 | - |
dc.identifier.bibliographicCitation | JAMA NEUROLOGY, Vol.74(10) : 1206-1215, 2017-10 | - |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.