, 2011; fuster, - weill cornell brain and spine

•

Rogers, Circulation, 2011; Fuster, Circulation, 2006

•

–

–

–

–

•

Fuster, Circulation, 2006

•

•

–

–

Fuster, Circulation, 2006

•

Fuster, Circulation, 2006

•

–

–

–

•

•

Lip, Chest, 2010

•

–

–

–

–

–

–

–

Friberg, Circulation, 2012

0

2

4

6

8

10

12

14

1 2 3 4 5 6 7 8 9 10

An

nu

al R

isk

of

Stro

ke

CHA2DS2VASc Score

Lip, Chest, 2010

Pisters, Chest, 2010

•

–

–

–

–

–

–

–

Pisters, Chest, 2010

0

2

4

6

8

10

12

14

1 2 3 4 5 6

An

nu

al R

isk

of

Ble

ed

ing

HASBLED Score

Figure.

The net clinical benefit of warfarin by age group (top) and CHADS2 score (bottom). Net clinical

benefit is plotted as the adjusted, weighted adverse events prevented per 100 person-years by

warfarin treatment, according to age group and CHADS 2 score, respectively. Intracranial

hemorrhage is weighted as 1.5 times the value of thromboembolism (see Methods section).

Stratified rates for CHADS2 score are not further adjusted. CHADS2 = Congestive Heart

Failure/Hypertension/Age/Diabetes/Prior Stroke2.

Singer et al. Page 12

Ann Intern Med. Author manuscript; available in PMC 2010 March 1.

NIH

-PA

Au

tho

r Ma

nuscrip

tN

IH-P

A A

uth

or M

anu

scrip

tN

IH-P

A A

uth

or M

an

uscrip

t

Fang, Ann Intern Med, 2009

•

•

•

•

–

–

–

•

–

•

–

Dabigatran Rivaroxaban Apixaban

Average age 72 73 70

Average CHADS2 2.1 3.5 2.1

Prior stroke/TIA 20% 55% 20%

Connolly, NEJM, 2009; Granger, NEJM, 2011; Patel, NEJM, 2011

Connolly, NEJM, 2009; Granger, NEJM, 2011; Patel, NEJM, 2011

Dabigatran Rivaroxaban Apixaban

Blinding Single Double Double

Sample size 18,113 14,264 18,201

Follow-up 2.0 yrs 1.9 yrs 1.8 yrs

Mean TTR 64% 55% 62%

Discontinued 21 v. 17% 24 v. 22% 25 v. 28%

Connolly, NEJM, 2009; Granger, NEJM, 2011; Patel, NEJM, 2011

Dabigatran Rivaroxaban Apixaban

Stroke: 0.66 0.79 0.79

ICH: 0.40 0.67 0.42

MI: 1.38 0.81 0.88

Death: 0.88 0.92 0.89

Connolly, NEJM, 2009; Granger, NEJM, 2011; Patel, NEJM, 2011

Dabigatran Rivaroxaban Apixaban

Stroke:

Active 1.11% 1.7% 1.27%

Warfarin 1.69% 2.2% 1.60%

ICH:

Active 0.30% 0.5% 0.33%

Warfarin 0.74% 0.7% 0.80%

Hart, Stroke, 2012; FDA, fda.gov, 2012

•

•

Freeman, Ann Intern Med, 2011; Shah, Circulation, 2011; Kamel, Stroke, 2011; Lee, Am J Cardiol, 2012; Lee, PLoS One, 2012; Kamel, Neurology, 2012

•

–

–

–

•

•

You, Chest, 2012; Cairns, Can J Cardiol, 2012

•

•

•

Donze, Am J Med, 2012; Healey, NEJM, 2012; You, Chest, 2012;

•

•

•

•

•

•

•

•