Efficacy and Safety of Apixaban in the Patients Undergoing the Ablation of Atrial Fibrillation

被引:41
作者
Nagao, Tomoyuki [1 ]
Inden, Yasuya [1 ]
Shimano, Masayuki [1 ]
Fujita, Masaya [1 ]
Yanagisawa, Satoshi [1 ]
Kato, Hiroyuki [1 ]
Ishikawa, Shinji [1 ]
Miyoshi, Aya [1 ]
Okumura, Satoshi [1 ]
Ohguchi, Shiou [1 ]
Yamamoto, Toshihiko [1 ]
Yoshida, Naoki [1 ,2 ]
Hirai, Makoto [3 ]
Murohara, Toyoaki [1 ]
机构
[1] Nagoya Univ, Grad Sch Med, Dept Cardiol, Nagoya, Aichi 4668550, Japan
[2] Univ Alabama Birmingham, Div Cardiovasc Dis, Birmingham, AL 35294 USA
[3] Nagoya Univ, Grad Sch Hlth Sci, Nagoya, Aichi 4668550, Japan
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2015年 / 38卷 / 02期
关键词
apixaban; atrial fibrillation; catheter ablation; RADIOFREQUENCY CATHETER ABLATION; FACTOR XA INHIBITOR; PERIPROCEDURAL ANTICOAGULATION; BLEEDING COMPLICATIONS; THROMBIN GENERATION; IN-VITRO; DABIGATRAN; WARFARIN; STROKE; MANAGEMENT;
D O I
10.1111/pace.12553
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
IntroductionApixaban, a factor Xa (FXa) inhibitor, is a new oral anticoagulant for stroke prevention in atrial fibrillation (AF). However, little is known about its efficacy and safety as a periprocedural anticoagulant therapy for patients who had undergone catheter ablation (CA) for AF. Methods and ResultsWe evaluated 342 consecutive patients who underwent CA for AF between April 2013 and March 2014 and received apixaban (n = 105) and warfarin (n = 237) for uninterrupted periprocedural anticoagulation. We retrospectively investigated the occurrence of bleeding and thromboembolic complications during the procedural period and compared them between the apixaban group (AG) and warfarin group (WG). Thromboembolic complications occurred in one (0.4%) patient in the WG. Major and minor bleeding complications occurred in one (1%) and four (4%) patients in the AG, and three (1%) and 12 (5%) patients in the WG. No significant difference in complications was observed between the AG and WG. Of importance, adverse event rates did not differ between the two groups after adjusting by a propensity score analysis. In preoperative tests of blood coagulation, there were significant differences in the prothrombin time, activated partial thromboplastin time, FXa activity, and prothrombin fragment 1 + 2 (F1+2) levels between the AG and WG. ConclusionThe use of apixaban during the periprocedural period of AF ablation seemed as efficacious and safe as warfarin.
引用
收藏
页码:155 / 163
页数:9
相关论文
共 36 条
[21]   Effective elimination of dabigatran by haemodialysis A phase I single-centre study in patients with end-stage renal disease [J].
Khadzhynov, Dmytro ;
Wagner, Frank ;
Formella, Stephan ;
Wiegert, Erol ;
Moschetti, Viktoria ;
Slowinski, Torsten ;
Neumayer, Hans-H. ;
Liesenfeld, Karl-Heinz ;
Lehr, Thorsten ;
Haertter, Sebastian ;
Friedman, Jeffrey ;
Peters, Harm ;
Clemens, Andreas .
THROMBOSIS AND HAEMOSTASIS, 2013, 109 (04) :596-605
[22]   Dabigatran vs warfarin for radiofrequency catheter ablation of atrial fibrillation [J].
Kim, Jin-Seok ;
She, Fei ;
Jongnarangsin, Krit ;
Chugh, Aman ;
Latchamsetty, Rakesh ;
Ghanbari, Hamid ;
Crawford, Thomas ;
Suwanagool, Arisara ;
Sinno, Mohammed ;
Carrigan, Thomas ;
Kennedy, Robert ;
Saint-Phard, Wouter ;
Yokokawa, Miki ;
Good, Eric ;
Bogun, Frank ;
Pelosi, Frank, Jr. ;
Morady, Fred ;
Oral, Hakan .
HEART RHYTHM, 2013, 10 (04) :483-489
[23]   Differences in intraprocedural ACTs with standardized heparin dosing during catheter ablation for atrial fibrillation in patients treated with dabigatran vs. patients on uninterrupted warfarin [J].
Konduru, Sai V. ;
Cheema, Aamir A. ;
Jones, Philip ;
Li, Yan ;
Ramza, Brian ;
Wimmer, Alan P. .
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2012, 35 (03) :277-284
[24]   Feasibility and Safety of Uninterrupted Rivaroxaban for Periprocedural Anticoagulation in Patients Undergoing Radiofrequency Ablation for Atrial Fibrillation [J].
Lakkireddy, Dhanunjaya ;
Reddy, Yeruva Madhu ;
Di Biase, Luigi ;
Vallakati, Ajay ;
Mansour, Moussa C. ;
Santangeli, Pasquale ;
Gangireddy, Sandeep ;
Swarup, Vijay ;
Chalhoub, Fadi ;
Atkins, Donita ;
Bommana, Sudharani ;
Verma, Atul ;
Sanchez, Javier E. ;
Burkhardt, J. David ;
Barrett, Conor D. ;
Baheiry, Salwa ;
Ruskin, Jeremy ;
Reddy, Vivek ;
Natale, Andrea .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2014, 63 (10) :982-988
[25]   Feasibility and Safety of Dabigatran Versus Warfarin for Periprocedural Anticoagulation in Patients Undergoing Radiofrequency Ablation for Atrial Fibrillation Results From a Multicenter Prospective Registry [J].
Lakkireddy, Dhanunjaya ;
Reddy, Yeruva Madhu ;
Di Biase, Luigi ;
Vanga, Subba Reddy ;
Santangeli, Pasquale ;
Swarup, Vijay ;
Pimentel, Rhea ;
Mansour, Moussa C. ;
D'Avila, Andre ;
Sanchez, Javier E. ;
Burkhardt, J. David ;
Chalhoub, Fadi ;
Mohanty, Prasant ;
Coffey, James ;
Shaik, Naushad ;
Monir, George ;
Reddy, Vivek Y. ;
Ruskin, Jeremy ;
Natale, Andrea .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2012, 59 (13) :1168-1174
[26]   Thrombogenicity of radiofrequency ablation procedures: what factors influence thrombin generation? [J].
Lee, DSY ;
Dorian, P ;
Downar, E ;
Burns, M ;
Yeo, EL ;
Gold, WL ;
Paquette, M ;
Lau, W ;
Newman, DM .
EUROPACE, 2001, 3 (03) :195-200
[27]   Dabigatran versus Warfarin Therapy for Uninterrupted Oral Anticoagulation During Atrial Fibrillation Ablation [J].
Maddox, William ;
Kay, G. Neal ;
Yamada, Takumi ;
Osorio, Jose ;
Doppalapudi, Harish ;
Plumb, Vance J. ;
Gunter, Alicia ;
Mcelderry, H. Thomas .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2013, 24 (08) :861-865
[28]   Effect of non-specific reversal agents on anticoagulant activity of dabigatran and rivaroxaban [J].
Marlu, Raphael ;
Hodaj, Enkelejda ;
Paris, Adeline ;
Albaladejo, Pierre ;
Crackowski, Jean Luc ;
Pernod, Gilles .
THROMBOSIS AND HAEMOSTASIS, 2012, 108 (02) :217-224
[29]   A new approach for catheter ablation of atrial fibrillation: Mapping of the electrophysiologic substrate [J].
Nademanee, K ;
McKenzie, J ;
Kosar, E ;
Schwab, M ;
Sunsaneewitayakul, B ;
Vasavakul, T ;
Khunnawat, C ;
Ngarmukos, T .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (11) :2044-2053
[30]   Radiofrequency catheter ablation of chronic atrial fibrillation guided by complex electrograms [J].
Oral, Hakan ;
Chugh, Aman ;
Good, Eric ;
Wimmer, Alan ;
Dey, Sujoya ;
Gadeela, Nitesh ;
Sankaran, Sundar ;
Crawford, Thomas ;
Sarrazin, Jean F. ;
Kuhne, Michael ;
Chalfoun, Nagib ;
Wells, Darryl ;
Frederick, Melissa ;
Fortino, Jackie ;
Benloucif-Moore, Suzanne ;
Jongnarangsin, Krit ;
Pelosi, Frank, Jr. ;
Bogun, Frank ;
Morady, Fred .
CIRCULATION, 2007, 115 (20) :2606-2612