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Education","award":["031L0239"],"award-info":[{"award-number":["031L0239"]}]},{"name":"Wolfgang Seefried project funding German Heart Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>Patients with long atrial high-rate episodes (AHREs) \u226524\u2005h and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared with no anticoagulation in these patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This secondary pre-specified analysis of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High-rate episodes (NOAH-AFNET 6) trial examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared with placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and electrocardiogram (ECG)-diagnosed atrial fibrillation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median follow-up of 2389 patients with core lab-verified AHRE was 1.8 years. AHRE \u226524 h were present at baseline in 259\/2389 patients (11%, 78 \u00b1 7 years old, 28% women, CHA2DS2-VASc 4). Clinical characteristics were not different from patients with shorter AHRE. The primary outcome occurred in 9\/132 patients with AHRE \u226524\u2005h (4.3%\/patient-year, 2 strokes) treated with anticoagulation and in 14\/127 patients treated with placebo (6.9%\/patient-year, 2 strokes). Atrial high-rate episode duration did not interact with the efficacy (P-interaction = .65) or safety (P-interaction = .98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE \u226524\u2005h developed more ECG-diagnosed atrial fibrillation (17.0%\/patient-year) than patients with shorter AHRE (8.2%\/patient-year; P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehad771","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T22:33:57Z","timestamp":1699914837000},"page":"837-849","source":"Crossref","is-referenced-by-count":47,"title":["Anticoagulation with edoxaban in patients with long atrial high-rate episodes \u226524\u2005h"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4476-1341","authenticated-orcid":false,"given":"Nina","family":"Becher","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, Hamburg 20246 , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/Luebeck , Postdamer Str. 58, 10785 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-0621","authenticated-orcid":false,"given":"Tobias","family":"Toennis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf , Martinistrasse 52, Hamburg 20246 , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Hamburg\/Kiel\/Luebeck , Postdamer Str. 58, 10785 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3878-2904","authenticated-orcid":false,"given":"Emanuele","family":"Bertaglia","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Vascular, Thoracic and Public Health Sciences, Azienda Ospedaliera , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-3903","authenticated-orcid":false,"given":"Carina","family":"Blomstr\u00f6m-Lundqvist","sequence":"additional","affiliation":[{"name":"Department of Medical Science, Uppsala University , Uppsala , Sweden"},{"name":"Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9145-6887","authenticated-orcid":false,"given":"Axel","family":"Brandes","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Esbjerg Hospital\u2014University Hospital of Southern Denmark , Esbjerg , Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark , Odense , 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