房颤的治疗回顾与展望课件.pptVIP

Background Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor.(一种新型口服直接凝血酶抑制剂) method In this noninferiority trial, we randomly assigned 18,113 patients who had atrial fibrillation and a risk of stroke to receive, in a blinded fashion, fixed doses of dabigatran — 110 mg or 150 mg twice daily — or, in an unblinded fashion, adjusted-dose warfarin. The median duration of the follow-up period was 2.0 years. The primary outcome was stroke or systemic embolism. * * 44个国家，951个临床中心。入选的房颤患者必须具备以下至少一条危险因素：既往卒中或TIA史、LVEF＜49%、NYHA＞II极或6个月内有心衰症状、 年龄≥75岁或65至74岁之间并伴有糖尿病、高血压、冠心病。最终入选人群中CHADS2 平均2.1分，≥ 2者约占2/3。主要终点是卒中和体循环栓塞，安全终点是严重的出血. 共入选18113人。平均随访2年。Dabigatran分为110mg每日两次组和150mg每日两次组。 结果卒中和体循环栓塞发生率110mg组和华法林组相同，150mg组低于华法林 严重出血发生率110mg组低于华法林组，150mg组与华法林相同 A Phase 3, Active (Warfarin) Controlled, Randomized, Double-Blind, Parallel Arm Study to Evaluate Efficacy and Safety of Apixaban in Preventing Stroke and Systemic Embolism in Subjects With Nonvalvular Atrial Fibrillation * A Phase III Study of Apixaban in Patients With AF The purpose of this clinical research study is to learn if apixaban is more effective than Acetylsalicylic Acid (ASA) in preventing strokes associated with subjects who have atrial fibrillation. The safety of this treatment will also be studied. * ROCKET AF TrialLead Physician: Toussaint Smith, MD, Memorial Hermann SouthwestThis prospective randomized, double-blind, double-dummy, parallel-group, international multi-center, event-driven, non-inferiority study compares the efficacy and safety of once-daily oral Rivaroxaban with adjusted-dose oral Warfarin for the prevention of stroke and non-central nervous system systemic embolism in subjects with non-valvular atrial fibrillation. Currently recruiting up to 14,000 subjects, the ROCKET AF study will continue through the end of 2010.For more information: Contact Julia Powers,