Atrial+Fibrillation

ASSERT: Healey et al, "Subclinical Atrial Fibrillation and the Risk of Stroke." NEJM 2012; 366:120-9. - Patients with no history of atrial fibrillation with pacemakers or defibrillators were monitored for subclinical atrial tachyarrhythmias for 3 months, and then followed up for a mean of 2.5 years for ischemic stroke or systemic embolism - Patients were randomly assigned to receive or not to receive continuous atrial overdrive pacing - 10.1% of patients had subclinical atrial tachyarrhythmias, with an increased risk of ischemic storke or systemic embolism (HR 2.5). Continuous atrial overdrive pacing did not prevent atrial fibrillation. [|PUBMED]


 * //RE-LY, 2009//**: Connolly et al, "Dabigatran versus Warfarin in Patients with Atrial Fibrillation." NEJM 2009. [|NEJM]
 * N=18,113
 * Follow-up: 2 years
 * Pts randomized to dabigatran 110mg BID, dabigatran 150mg BID, or adjusted-dose warfarin
 * Dabigatran 150mg BID was superior to warfarin with regards to lower rates of stroke and systemic embolism but similar rates of major hemorrhage as warfarin.

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 * //ROCKET AF, 2011:// Patel et al, "Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation." NEJM 2011. [|NEJM] **
 * N=14,264
 * Rivaroxaban 20mg daily versus adjusted-dose warfarin
 * Rivaroxaban was noninferior to warfarin for prevention of stroke or systemic embolism. There was no significant between-group difference in the risk of major bleeding, although intracranial and fatal bleeding occurred less frequently in the rivaroxaban group
 * //ARISTOTLE, 2011:// Granger et al, "Apixaban versus Warfarin in Patients with Atrial Fibrillation." NEJM 2011. [|NEJM] **
 * N=18,201
 * Pts randomized to apixaban 5mg BID vs adjusted-dose warfarin
 * mean follow-up 1.8 years
 * Apixaban was superior to warfarin in preventing stroke or systemic embolism, caused fewer hemorrhagic strokes, and had a lower death from any cause