Assessing Edoxaban for Stroke Prevention in patients with Atrial High-Rate Episodes
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on October 18th, 2023
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Oral anticoagulants are commonly used to manage ischemic stroke in atrial fibrillation patients. However, the efficacy of anticoagulants in patients with atrial high-rate episodes (AHREs), a subclinical form of atrial fibrillation, remains uncertain. To address this, the German Center for Cardiovascular Research sponsored a study to investigate the potential benefits of edoxaban in patients with AHREs.
The study comprised 2536 participants aged 65 and older, all of whom had implanted devices capable of detecting AHREs. These episodes were defined by an atrial rate of at least 170 beats per minute lasting longer than 6 minutes. Among the participants, 86.9% had a history of hypertension, 27.4% had heart failure, 10% had experienced at least one stroke episode, and 26.4% had a previous myocardial infarction. Patients were randomly assigned to receive either a placebo or a daily 60 mg dose of edoxaban. After a 21-month investigation, the researchers found that edoxaban did not reduce the risk of stroke or systemic embolism. However, the use of edoxaban may have posed a potential harm, significantly increasing the risk of death due to excessive bleeding.
The study comprised 2536 participants aged 65 and older, all of whom had implanted devices capable of detecting AHREs. These episodes were defined by an atrial rate of at least 170 beats per minute lasting longer than 6 minutes. Among the participants, 86.9% had a history of hypertension, 27.4% had heart failure, 10% had experienced at least one stroke episode, and 26.4% had a previous myocardial infarction. Patients were randomly assigned to receive either a placebo or a daily 60 mg dose of edoxaban. After a 21-month investigation, the researchers found that edoxaban did not reduce the risk of stroke or systemic embolism. However, the use of edoxaban may have posed a potential harm, significantly increasing the risk of death due to excessive bleeding.