Browsing by Author "Swiss Cardiovascular Center, University Hospital Bern"

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    The long-term multicenter observational study of dabigatran treatment in patients with atrial fibrillation (RELY-ABLE) study
    (2013-07-16) Stuart J. Connolly; Lars Wallentin; Michael D. Ezekowitz; John Eikelboom; Jonas Oldgren; Paul A. Reilly; Martina Brueckmann; Janice Pogue; Marco Alings; John V. Amerena; Alvaro Avezum; Iris Baumgartner; Andrzej J. Budaj; Jyh Hong Chen; Antonio L. Dans; Harald Darius; Giuseppe Di Pasquale; Jorge Ferreira; Greg C. Flaker; Marcus D. Flather; Maria Grazia Franzosi; Sergey P. Golitsyn; David A. Halon; Hein Heidbuchel; Stefan H. Hohnloser; Kurt Huber; Petr Jansky; Gabriel Kamensky; Matyas Keltai; Sung Soon Kim; Chu Pak Lau; Jean Yves Le Heuzey; Basil S. Lewis; Lisheng Liu; John Nanas; Razali Omar; Prem Pais; Knud E. Pedersen; Leopoldo S. Piegas; Dimitar Raev; Pal J. Smith; Mario Talajic; Ru San Tan; Supachai Tanomsup; Lauri Toivonen; Dragos Vinereanu; Denis Xavier; Jun Zhu; Susan Q. Wang; Christine O. Duffy; Ellison Themeles; Salim Yusuf; Population Health Research Institute, Ontario; Akademiska Sjukhuset; Boehringer Ingelheim Pharmaceuticals, Inc.; Boehringer Ingelheim Pharma GmbH & Co. KG; Universitat Heidelberg; Amphia Hospital; Deakin University; Instituto Dante Pazzanese de Cardiologia; Swiss Cardiovascular Center, University Hospital Bern; Szpital Grochowski, Warszawa; National Cheng Kung University; University of the Philippines Manila; Vivantes Neukoelln Medical Center; Ospedale Maggiore; Lankenau Institute for Medical Research; Hospital de Santa Cruz, Carnaxide; University of Missouri-Columbia; Royal Brompton Hospital; Istituto di Ricerche Farmacologiche Mario Negri; National Medical Research Center of Cardiology, Moscow; Carmel Medical Center; KU Leuven; Goethe-Universitat Frankfurt am Main; Wiener Krakenanstaltenverbund; Fakultni Nemocnice v Motole; University Hospital in Bratislava; Semmelweis Egyetem; Yonsei University College of Medicine; The University of Hong Kong; Universite Paris Descartes; Fuwai Hospital; University of Athens; Institut Jantung Negara Kuala Lumpur; St. John's Medical College; Odense Universitetshospital; Ministry of Interior; Akershus University Hospital; Institut de Cardiologie de Montreal; National Heart Centre, Singapore; Mahidol University; Helsinki University Hospital; Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
    BACKGROUND - : During follow-up of between 1 and 3 years in the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial, 2 doses of dabigatran etexilate were shown to be effective and safe for the prevention of stroke or systemic embolism in patients with atrial fibrillation. There is a need for longer-term follow-up of patients on dabigatran and for further data comparing the 2 dabigatran doses. METHODS AND RESULTS - : Patients randomly assigned to dabigatran in RE-LY were eligible for the Long-term Multicenter Extension of Dabigatran Treatment in Patients with Atrial Fibrillation (RELY-ABLE) trial if they had not permanently discontinued study medication at the time of their final RE-LY study visit. Enrolled patients continued to receive the double-blind dabigatran dose received in RE-LY, for up to 28 months of follow up after RE-LY (median follow-up, 2.3 years). There were 5851 patients enrolled, representing 48% of patients originally randomly assigned to receive dabigatran in RE-LY and 86% of RELY-ABLE-eligible patients. Rates of stroke or systemic embolism were 1.46% and 1.60%/y on dabigatran 150 and 110 mg twice daily, respectively (hazard ratio, 0.91; 95% confidence interval, 0.69-1.20). Rates of major hemorrhage were 3.74% and 2.99%/y on dabigatran 150 and 110 mg (hazard ratio, 1.26; 95% confidence interval, 1.04-1.53). Rates of death were 3.02% and 3.10%/y (hazard ratio, 0.97; 95% confidence interval, 0.80-1.19). Rates of hemorrhagic stroke were 0.13% and 0.14%/y. CONCLUSIONS - : During 2.3 years of continued treatment with dabigatran after RE-LY, there was a higher rate of major bleeding with dabigatran 150 mg twice daily in comparison with 110 mg, and similar rates of stroke and death. CLINICAL TRIAL REGISTRATION - : URL: http://www.clinicaltrials.gov. Unique identifier: NCT00808067. © 2013 American Heart Association, Inc.
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    Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: Insights from the REACH registry
    (2014-01-01) Dharam J. Kumbhani; Gabriel Steg; Christopher P. Cannon; Kim A. Eagle; Sidney C. Smith; Shinya Goto; E. Magnus Ohman; Yedid Elbez; Piyamitr Sritara; Iris Baumgartner; Subhash Banerjee; Mark A. Creager; Deepak L. Bhatt; UT Southwestern Medical Center; Universite Paris 7- Denis Diderot; Inserm; Hopital Bichat-Claude-Bernard AP-HP; Royal Brompton Hospital; Harvard Medical School; TIMI Study Group; University of Michigan, Ann Arbor; The University of North Carolina at Chapel Hill; Tokai University School of Medicine; Duke University; Mahidol University; Swiss Cardiovascular Center, University Hospital Bern; VA Medical Center
    © 2014 The Author. Aims Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic PAD enrolled in the international REACH registry. Methods Statin use was assessed at study enrolment, as well as a time-varying covariate. Rates of the primary adverse limb outcome (worsening claudication/new episode of critical limb ischaemia, new percutaneous/surgical revascularization, or amputation) at 4 years and the composite of cardiovascular death/myocardial infarction/stroke were compared among statin users vs. non-users. Results A total of 5861 patients with symptomatic PAD were included. Statin use at baseline was 62.2%. Patients who were on statins had a significantly lower risk of the primary adverse limb outcome at 4 years when compared with those who were not taking statins [22.0 vs. 26.2%; hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.72-0.92; P = 0.0013]. Results were similar when statin use was considered as a time-dependent variable (P = 0.018) and on propensity analysis (P < 0.0001). The composite of cardiovascular death/myocardial infarction/stroke was similarly reduced (HR, 0.83; 95% CI, 0.73-0.96; P = 0.01). Conclusion Among patients with PAD in the REACH registry, statin use was associated with an ∼18% lower rate of adverse limb outcomes, including worsening symptoms, peripheral revascularization, and ischaemic amputations. These findings suggest that statin therapy not only reduces the risk of adverse cardiovascular events, but also favourably affects limb prognosis in patients with PAD.