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antithrombotics in atrial fibrillation for primary prevention of thromboembolic events, clinical trials results

apixaban versus aspirin
AVERROES, 2011
NCT00496769
apixaban 5 mg (or 2.5 mg) twice daily
versus
aspirin 81-324 md daily
patients with atrial fibrillation who have failed or are unsuitable for vitamin K antagonist treatmentdouble blind
Follow-up duration: maximum 21 months
36 countries
apixaban versus warfarin standard dose
ARISTOTLE, 2011
NCT00412984
apixaban 5mg twice daily
versus
warfarin adjusted for an INR between 2 and 3
subjects with atrial fibrillation and risk factors for stroke double blind
Follow-up duration: 1.8 yrs (median)
39 countries
phase 2 apixaban, 0
NCT00787150
apixaban 5 or 2.5 mg twice daily
versus
warfarin
patient with non valvular AFdouble blind
Follow-up duration: 12 weeks
aspirin versus control
Japanese AF Trial, 2006
aspirin at 150 to 200 mg per day
versus
no antiplatelet or anticoagulant therapy
patients with nonvalvular atrial fibrillation
LASAF(aspirin vs no treatment), 1999
aspirin:125mg/day(group A1);125mg on alternate days(group A2)
versus
no control treatment(group C)
Open
aspirin versus coumadin low dose
PATAF (vs coumadin low dose), 1999
aspirin 300mg/d
versus
coumarin low dose(target INR 1.1-1.6 )
non rheumatic AF,recruited in general practice,with no established indication for anticoagulation.Simple aveugle
Follow-up duration: 2.7 years
Netherlands
aspirin versus coumadin standard dose
PATAF (vs coumadin standard dose), 1999
aspirin 150mg/d
versus
coumarin standard dose(target INR 2.5-3.5)
non rheumatic AF,recruited in general practice,with no established indication for anticoagulation.Simple aveugle
Follow-up duration: 2.7 years
Netherlands
aspirin versus placebo
AFASAK (aspirin vs placebo), 1989
aspirin 75 mg/d
versus
placebo
patients with chronic non-rheumatic atrial fibrillation Double aveugle
Follow-up duration: 2 years
Denmark
SPAF (aspirin , warfarin eligible arm), 1991
aspirin 325mg/d
versus
placebo
nonrheumatic atrial fibrillation,warfarin eligible patientsDouble blind
Follow-up duration: 1.3 years
USA
SPAF (aspirin,warfarin ineligible arm), 1991
aspirin 325mg/d
versus
placebo
nonrheumatic atrial fibrillation, warfarin ineligible patientsDouble blind
Follow-up duration: 1.3 years
USA
aspirin versus warfarin low dose
AFASAK II (aspirin vs warfarin low dose), 1998
aspirin 300 mg/d
versus
warfarin low dose (1.25mg/d)
chronic non valvular atrial fibrillationOpen
Follow-up duration: 3.5 years
Denmark
aspirin versus warfarin standard dose
AFASAK (aspirin vs warfarin standard dose), 1989
aspirin (low dose 75 mg)
versus
warfarin standard dose(target INR 2.8-4.2)
chronic non rheumatic AFOpen
Follow-up duration: 2 years
Denmark
AFASAK II (aspirin vs warfarin standard dose), 1998
aspirin 300 mg/d
versus
warfarin standard dose(target INR 2-3)
chronic non valvular atrial fibrillationOpen
Follow-up duration: 3.5 years
Denmark
SPAF II (aspirin vs warfarin standard dose, age<75), 1994
aspirin 325 mg/d
versus
warfarin standard dose(target INR 2.0-4.5)
non rheumatic atrial fibrillation,medium to high risk patients. Patients aged 75 and less.Open
Follow-up duration: 3.1 years
USA
SPAF II (aspirin vs warfarin standard dose, age>75), 1994
aspirin 325 mg/d
versus
warfarin standard dose (target INR 2.0-4.5)
Non rheumatic atrial fibrillation,medium to high risk patients.Patients aged more than 75.Open
Follow-up duration: 2.0 years
USA
aspirin + clopidogrel versus anticoagulant
ACTIVE W, 2006
NCT00243178
clopidogrel (75 mg per day) plus aspirin (75–100 mg per day)
versus
oral anticoagulation therapy (target international normalised ratio of 2·0–3·0)
Patients with atrial fibrillation plus one or more risk factor for strokeopen
Follow-up duration: 1.28 y (median)
aspirin + clopidogrel versus aspirin
ACTIVE A, 2009
NCT00249873
clopidogrel 75 mg daily + aspirin 75-100 mg daily
versus
aspirin 75-100 mg daily alone
Patients with AF and at least one risk factor for stroke and who are not candidates for warfarin therapydouble blind
Follow-up duration: 3.7 y
AZD0837 versus aspirin
phase 2 AZD0837, 0
NCT00623779
AZD0837
versus
aspirin
patients with atrial fibrillation, who are appropriate for but unable or unwilling to take Vitamin-K antagonist(VKA) therapyopen
AZD0837 versus warfarin standard dose
Lip (phase 2 AZD0837), 2009
NCT00684307
AZD0837 for 3-9 months
versus
dose-adjusted Vitamin-K antagonists (VKA) (aiming for an international normalized ratio (INR) 2.0 to 3.0)
patients with non-valvular atrial fibrillation (AF) with one or more additional risk factors for strokedouble blind
Follow-up duration: 3 or 9 months
coumadin low dose versus coumadin standard dose
PATAF (coumadin low dose vs coumadin standard dose), 1999
coumarin low dose(target INR 1.1-1.6)
versus
coumarin standard dose(target INR 2.5-3.5)
non rheumatic AF,recruited in general practice,with no established indication for anticoagulation.Simple aveugle
Follow-up duration: 2.7 years
Netherlands
dabigatran versus warfarin standard dose
phase 2 dabigatran, 0
NCT01136408
Dabigatran 110, 220, 300 mg twice daily
versus
warfarin
patients with non-valvular atrial fibrillation (paroxysmal, persistent or permanent)open
Japan
dabigatran 110mg versus warfarin standard dose
RE-LY (110mg), 2009
NCT00262600
dabigatran 110 mg twice a day
versus
warfarin adjusted dose to a 2-3 INR
Patients With Non-Valvular Atrial Fibrillation open (blind assessment)
Follow-up duration: 2 y (median)
44 countries
dabigatran 150mg versus warfarin standard dose
PETRO (150mg), 2007
dabigatran 150 mg twice daily (alone or combined with 81- or 325-mg aspirin)
versus
warfarin administered to achieve an international normalized ratio of 2 to 3 for
patients with AF at high risk for thromboembolic eventsdouble blind
Follow-up duration: 12 weeks
Denmark, The netehrlands, Sweden, US
RE-LY (150mg), 2009
NCT00262600
dabigatran 150 mg twice a day
versus
warfarin adjusted-dose to a 2.0 to 3.0 INR
Patients With Non-Valvular Atrial Fibrillationopen (blind assessment)
Follow-up duration: 2 y (median)
44 countries
edoxaban versus warfarin standard dose
Weitz (edoxaban phase 2), 0
NCT00504556
Four Fixed Dose Regimens of edoxaban (DU-176b)
versus
warfarin
Subjects With Non- Valvular Atrial Fibrillationdouble-blind
Follow-up duration: 3 months
USA, Europe, South and central america,
phase 2 edoxaban, 0
NCT00806624
edoxaban (DU-176b)
versus
warfarin
male and female subjects aged 18 to 80 years, inclusive, with non-valvular AF and a CHADS2 Score of at least 1double-blind
China
edoxaban high dose versus warfarin standard dose
ENGAGE-AF TIMI 48 High dose, 2013
NCT00781391
edoxaban 60mg once daily
versus
warfarin (INR 2-3)
AF patients (CHADS2 >=2) double blind
Follow-up duration: 2.8 years
46 countries
edoxaban low dose versus warfarin standard dose
ENGAGE-AF TIMI 48 Low dose, 2013
NCT00781391
edoxaban xxx once daily
versus
warfarin (INR 2-3)
AF patients (CHADS2 >=2) double blind
Follow-up duration: 2.8 years
46 countries
idraparinux versus warfarin standard dose
AMADEUS, 2008
NCT00070655
subcutaneous idraparinux 2·5 mg weekly
versus
adjusted-dose vitamin K antagonists (target of an international normalised ratio of 2–3)
patients with atrial fi brillation at risk for thromboembolismopen
Follow-up duration: 10.7 months
rivaroxaban versus warfarin standard dose
ROCKET-AF, 2010
NCT00403767
Rivaroxaban 20mg p.o. once daily
versus
Warfarin p.o. once daily titrated to a target INR of 2.5 (range 2.0 to 3.0, inclusive)
Subjects With Non-Valvular Atrial Fibrillationdouble blind
Follow-up duration: median 1.94 y
45 countries
triflusal versus coumadin standard dose
NASPEAF (triflusal vs coumadin standard dose)), 2004
Triflusal 600 mg/d
versus
coumadin standard dose(target INR 2-3)
Non valvular atrial fibrillation. Intermediate risk patients.Open
Follow-up duration: 2.76 years
Spain
triflusal+coumadin medium dose versus coumadin standard dose
NASPEAF (triflusal + coumadin medium dose vs coumadin standard dose), 2004
Triflusal 600 mg/d + coumadin medium dose (target INR 1.25-2)
versus
coumadin standard dose(target INR 2-3)
Non valvular atrial fibrillation. Intermediate risk patients.Open
Follow-up duration: 2.76 years
Spain
triflusal+coumadin medium dose versus triflusal
NASPEAF (triflusal+coumadin medium dose vs triflusal), 2004
Triflusal 600 mg/d + coumadin medium dose (target INR 1.25-2)
versus
Triflusal 600 mg/d
Non valvular atrial fibrillation. Intermediate risk patientsOpen
Follow-up duration: 2.76 years
Spain
warfarin + aspirin versus warfarin standard dose
AFASAK II (warfarin low dose+aspirin vs warfarin standard dose), 1998
warfarin fixed low dose(1.25mg/d) + aspirin(300mg/d)
versus
warfarin standard dose(target INR 2.0-3.0)
chronic non valvular atrial fibrillationOpen
Follow-up duration: 3.5 years
Denmark
SPAF III, 1996
warfarin low dose(target INR 1.2-1.5)+ aspirin 325 mg/d
versus
warfarin standard dose(target INR 2.0-3.0)
non rheumatic atrial fibrillation,patients with at least one additional thromboembolic risk factor(high risk patients)Open
Follow-up duration: 1.1 years
USA,Canada
warfarin low dose versus control
BAATAF (warfarin vs no treatment), 1990
NCT00000517
warfarin low dose (target INR:1.5-2.7)
versus
no placebo.people received no treatment but could choose to take aspirin.
non rheumatic AFOpen
Follow-up duration: 2.2 years
warfarin low dose versus placebo
SPINAF (warfarin vs placebo), 1992
warfarin low dose(target INR 1.4-2.8)
versus
placebo
men ,with chronic nonrheumatic atrial fibrillationDouble blind
Follow-up duration: 1.75 years
usa
warfarin low dose versus warfarin standard dose
AFASAK II (warfarin low dose vs warfarin standard dose), 1998
warfarin fixed low dose (1.25 mg/d)
versus
warfarin standard dose(target INR 2-3)
chronic non valvular atrial fibrillationOpen
Follow-up duration: 3.5 years
Denmark
MWNAF, 1998
warfarin low dose (1.25mg/d)
versus
warfarin standard dose( target INR 2.0-3.0)
Patients over 60 with non rheumatic atrial fibrillationOpen
Follow-up duration: 14.5 months
Italy
warfarin low dose + aspirin versus control
SAFT(warfarin low dose + aspirin vs no treatment), 2003
warfarin low dose (1.25 mg/d) + aspirin 75 mg/d
versus
no treatment
Low-medium risk patients with non valvular atrial fibrillation.Open
Follow-up duration: 33 months
Sweden
warfarin standard dose versus control
AFASAK (warfarin standard dose vs control), 1989
warfarin standard dose(target INR:2.8-4.2)
versus
control
chronic non rheumatic AFOpen
Follow-up duration: 2 years
Denmark
SPAF (warfarin standard dose), 1991
warfarin standard dose(target INR:2.0-4.5)
versus
control
Open
Follow-up duration: 1.3 years
USA
warfarin standard dose versus placebo
CAFA, 1991
warfarin standard dose (target INR 2-3)
versus
placebo
non rheumatic atrial fibrillationDouble blind
Follow-up duration: 15.2 months
canada
ximelagatran versus warfarin standard dose
SPORTIF V, 2005
ximelegatran 36 mg twice daily
versus
warfarin standard dose(target INR 2-3)
One or more stroke risk factor in addition to atrial fibrillation.High risk patients with non valvular atrial fibrillation. Double blind
Follow-up duration: 20 months
north america
SPORTIF II (ximelagatran vs warfarin standard dose), 2002
ximelegatran 20,40,60 mg twice daily
versus
warfarin standard dose(target INR 2-3)
Medium to high risk patients with chronic non valvular atrial fibrillation. Open
Follow-up duration: 16 weeks
Europe ,USA
SPORTIF III, 2003
ximelagatran 36 mg twice daily
versus
warfarin standard dose (target INR 2-3)
One or more stroke risk factor in addition to AF.High risk patients with non valvular atrial fibrillation.Open
Follow-up duration: 17.4 months
europe,asia,australasia
YM150 versus warfarin standard dose
phase 2 YM150, 0
NCT00448214
YM150 ASTELLAS
versus
warfarin
subjects with non-valvular atrial fibrillation open
Australia

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