作者
Jeff S Healey, Renato D Lopes, Christopher B Granger, Marco Alings, Lena Rivard, William F McIntyre, Dan Atar, David H Birnie, Giuseppe Boriani, A John Camm, David Conen, Julia W Erath, Michael R Gold, Stefan H Hohnloser, John Ip, Josef Kautzner, Valentina Kutyifa, Cecilia Linde, Philippe Mabo, Georges Mairesse, Juan Benezet Mazuecos, Jens Cosedis Nielsen, Francois Philippon, Marco Proietti, Christian Sticherling, Jorge A Wong, David J Wright, Ignatius G Zarraga, Shelagh B Coutts, Andrew Kaplan, Marta Pombo, Felix Ayala-Paredes, Lizhen Xu, Kim Simek, Sandra Nevills, Rajibul Mian, Stuart J Connolly
发表日期
2024/1/11
期刊
New England Journal of Medicine
卷号
390
期号
2
页码范围
107-117
出版商
Massachusetts Medical Society
简介
Background
Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit.
Methods
We conducted a trial involving patients with subclinical atrial fibrillation lasting 6 minutes to 24 hours. Patients were randomly assigned in a double-blind, double-dummy design to receive apixaban at a dose of 5 mg twice daily (2.5 mg twice daily when indicated) or aspirin at a dose of 81 mg daily. The trial medication was discontinued and anticoagulation started if subclinical atrial fibrillation lasting more than 24 hours or clinical atrial fibrillation developed. The primary efficacy outcome, stroke or systemic embolism, was assessed in the intention-to-treat population (all the …
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