ROCKET AF study – Is the end of warfarin coming?
Authors:
J. Špinar 1; J. Vítovec 2
Authors‘ workplace:
Interní kardiologická klinika LF MU a FN Brno-Bohunice
1; Interní kardiangiologická klinika LF MU a FN u sv. Anny v Brně
2
Published in:
Kardiol Rev Int Med 2011, 13(2): 106-108
Overview
Anti-coagulation therapy is the basis of the treatment of atrial fibrillations in all their variations. This therapy consists in the administration of vitamin K antagonists, in our conditions warfarin. This requires strict INR monitoring, where INR < 2.0 means an inefficient treatment while INR > 3.0 means a high risk of haemorrhage. The American Heart Association considers studies involving drugs that are to replace warfarin in patients with atrial fibrillations to be one of the 10 most important discoveries of 2010. They are the RE-LY, ROCKET AF and AVEROES studies. The ROCKET AF study has demonstrated in 14,246 patients a trend towards a reduction in CMP and systemic embolisation in the treatment with rivaroxaban compared to warfarin, without increasing the haemorrhage risk. The number of incidents per 100 patient-years was 1.71 with rivaroxaban therapy and 2.16 with warfarin therapy (p < 0.001 for non-inferiority). In February 2011, the ARISTOTLE study with apixaban was completed and the ENGAGE study with edoxaban is in progress.
Keywords:
atrial fibrillation – warfarin – rivaroxaban
Sources
1. Camm AJ, Kirchhof P, Lip GYH et al. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery. Guidelines for the management of atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31: 2369–2429.
2. Ezekowitz MD, Conolly S, Pareth A et al. Rationale and design of RE-LY randomised evaluation of long term antikoagulant therapy, warfarin compared with dabigatran. Am Heart J 2009; 157: 805–810.
3. Conolly SJ, Ezekowitz MD, Yusuf S et al. RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361: 1139–1151.
4. Špinar J, Vítovec J. Komu zvoní hrana? Kardiol Rev 2009; 11: 197–199.
Labels
Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2011 Issue 2
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