| Title |
Edoxaban Versus Warfarin in Latin American Patients With Atrial Fibrillation The ENGAGE AF-TIMI 48 Trial
|
|---|---|
| Published in |
JACC, September 2018
|
| DOI | 10.1016/j.jacc.2018.07.037 |
| Pubmed ID | |
| Authors |
Ramón Corbalán, José Carlos Nicolau, José López-Sendon, Armando Garcia-Castillo, Rodrigo Botero, Gustavo Sotomora, Manuel Horna, Christian T. Ruff, Rose A. Hamershock, Laura T. Grip, Elliott M. Antman, Eugene Braunwald, Robert P. Giugliano |
| Abstract |
There is limited information about the use of antithrombotic therapies and outcomes of Latin American (LatAm) subjects with atrial fibrillation. The global ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation Atrial Fibrillation-Thrombolysis In Myocardial Infarction 48) trial compared the efficacy and safety of edoxaban versus warfarin over a median follow-up of 2.8 years. The authors aimed to compare adjusted outcomes in Latin America versus outside Latin America and to compare outcomes stratified by anticoagulant treatment and region. The authors analyzed clinical characteristics and outcomes, adjusted for baseline characteristics, the Human Development Index, and randomized treatment of 2,661 LatAm versus 18,444 non-Latin American subjects (nLAS). When compared with nLAS, LatAm subjects had a similar overall risk for stroke. After multivariate adjustment, the risks of stroke/systemic embolism (hazard ratio [HR]: 1.19; 95% confidence interval (CI): 0.96 to 1.47; p = 0.11) and major bleeding (HR: 1.10; 95% CI: 0.89 to 1.36; p = 0.39) were similar in LatAm and nLAS. LatAm subjects were at higher adjusted risk of death (HR: 1.48; 95% CI: 1.30 to 1.69; p < 0.001) and intracranial hemorrhage (ICH) (HR: 1.55; 95% CI: 1.00 to 2.41; p = 0.049). In both regions, when compared with warfarin, edoxaban reduced stroke/systemic embolism (HR: 0.64 and 0.91 in LatAm and nLAS, respectively), major bleeding (HR: 0.71 and 0.82), and cardiovascular death (HR: 0.78 and 0.88), without evidence of regional heterogeneity (pint = 0.41, 0.50, and 0.70, respectively). There was a greater reduction in hemorrhagic stroke with edoxaban in LatAm (HR: 0.16) than in nLAS (HR: 0.64; pint = 0.037). After multivariable adjustment, LatAm subjects with atrial fibrillation had higher rates of intracranial hemorrhage and death than nLAS. Outcomes with higher-dose edoxaban versus warfarin were at least as favorable in LatAm subjects as in nLAS, with an even greater reduction in hemorrhagic stroke seen in LatAm. |
X Demographics
The data shown below were collected from the profiles of 21 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 4 | 19% |
| Colombia | 3 | 14% |
| United States | 2 | 10% |
| Argentina | 1 | 5% |
| Unknown | 11 | 52% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 18 | 86% |
| Scientists | 1 | 5% |
| Practitioners (doctors, other healthcare professionals) | 1 | 5% |
| Science communicators (journalists, bloggers, editors) | 1 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 72 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 72 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 9 | 13% |
| Student > Postgraduate | 8 | 11% |
| Other | 4 | 6% |
| Student > Ph. D. Student | 4 | 6% |
| Student > Master | 4 | 6% |
| Other | 10 | 14% |
| Unknown | 33 | 46% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 23 | 32% |
| Nursing and Health Professions | 4 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 6% |
| Agricultural and Biological Sciences | 2 | 3% |
| Sports and Recreations | 1 | 1% |
| Other | 3 | 4% |
| Unknown | 35 | 49% |
Attention Score in Context
This research output has an Altmetric Attention Score of 20. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 May 2020.
All research outputs
#1,900,780
of 25,728,855 outputs
Outputs from JACC
#4,167
of 16,932 outputs
Outputs of similar age
#38,397
of 346,671 outputs
Outputs of similar age from JACC
#122
of 248 outputs
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