Corrigendum to “Effectiveness and Safety of Oral Anticoagulants in Adults with Non-valvular Atrial Fibrillation Patients and Concomitant Coronary/Peripheral Artery Disease” American Journal of Medicine 131:09 (2018): 1074-1085.e4

Abstract Objectives The risk of atrial fibrillation (AF) and stroke in patients with peripheral artery disease (PAD) is an important and inadequately addressed issue. Our aim was to examine temporal trends in the incidence of AF and stroke in patients with PAD. Methods Danish nationwide registers were used to identify all patients aged ≥18 years, with first-time diagnosis of PAD between 1997 and 2015. Age-standardized incidence rates per 1.000 person-years were calculated to estimate trends of AF and stroke. Risk of AF and stroke was furthermore estimated by 1-year cumulative-incidence divided into four year-groups. Results A total of 121.211 patients with first-time diagnosis of PAD were included. The 1-year cumulative-incidence of AF in patients with PAD were 1.97% for year 1997–2000, 2.63% for year 2001–2005, 2.66% for year 2006–2010, and 2.78% for year 2011–2015, respectively. The 1-year cumulative-incidence of stroke in patients with PAD were 2.71%, 2.71%, 1.95%, and 1.81%, for the 1997–2000, 2001–2005, 2006–2010, and 2011–2015 year-groups respectively. Likewise, the age-standardized incidence rates showed increasing trends of AF during the study period whereas trends of stroke demonstrated a decline (Figure 1). All age-standardized trends were statistically significant (p<0.05). During the course of study i.e., between 1997 and 2015, the initiation of cholesterol-lowering agents, clopidogrel, and oral anticoagulants increased markedly from 7.0% to 51.3%, 0.1% to 5.9%, and 0.0% to 0.7%, respectively. Figure 1 Conclusion The incidence of AF in patients with PAD has significantly increased over time whereas a marked decline has occurred in the incidence of stroke. This suggests that the secondary prevention strategies aimed at reducing risk of stroke are broadly effective. Moreover, due to global aging, earlier and more frequent diagnosis, and improved treatment of cardiovascular risk factors may explain the increasing incidence of AF.

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Non-Vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation and Peripheral Artery Disease: a Systematic Review and Meta-Analysis

Cardiovascular Drugs and Therapy ◽

10.1007/s10557-020-06962-6 ◽

2020 ◽

Vol 34 (3) ◽

pp. 391-399 ◽

Cited By ~ 2

Author(s):

Xiang-Zhong Liao ◽

Yong-Hui Fu ◽

Jian-Yong Ma ◽

Wen-Gen Zhu ◽

Ping Yuan

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Peripheral Artery Disease ◽

Vitamin K ◽

Meta Analysis ◽

Oral Anticoagulants ◽

Vitamin K Antagonist ◽

Peripheral Artery ◽

Artery Disease

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Novel Oral Anticoagulants in Peripheral Artery Disease: Current Evidence

Current Pharmaceutical Design ◽

10.2174/1381612825666181226151959 ◽

2019 ◽

Vol 24 (38) ◽

pp. 4511-4515 ◽

Cited By ~ 1

Author(s):

A. Koutsoumpelis ◽

C. Argyriou ◽

K.M. Tasopoulou ◽

E.I. Georgakarakos ◽

G.S. Georgiadis

Keyword(s):

Peripheral Artery Disease ◽

Oral Anticoagulants ◽

Novel Oral Anticoagulants ◽

Current Evidence ◽

Peripheral Artery ◽

Cardiac Events ◽

Traditional Therapy ◽

Cardiovascular Morbidity And Mortality ◽

Increased Risk ◽

Artery Disease

Background: Peripheral artery disease is a common manifestation of systemic atherosclerosis which strongly correlates to cardiovascular morbidity and mortality. In addition, the progression of peripheral artery disease leads to an increased risk of limb loss. In order to reduce these events, the benchmark of treatment and research over the last years has been the antiplatelet therapy which aims at inhibition of platelet aggregation. Over the last years, new studies combining antiplatelet agents in different therapeutic schemes have been proven efficacious. Unfortunately, patients remain still at high risk of CV events. Novel Oral Anticoagulants have been introduced as alternatives to warfarin, in the prevention and treatment of venous thromboembolism. The rationale of using medication which acts on platelet activation and the coagulation pathway of thrombosis has led investigators to examine the role of Noac's in preventing CV events in patients with peripheral artery disease, stable or unstable. Methods: The aim of this study is to review the current evidence with respect to recently published studies concerning the use of Novel anticoagulants in peripheral artery disease. Results: The Compass trial has shown that a combination of rivaroxaban with traditional therapy may produce promising results in reducing amputation rates, stroke, cardiac events, and mortality, however, there are still safety issues with bleeding requiring acute care. The ePAD study has provided us with insight concerning safety and efficacy after peripheral angioplasty or stenting and actually the need for further research. The Voyager Pad study, following the steps of Compass, is studying the effect and safety of the addition of rivaroxaban to traditional therapy in the highest risk population aka patients undergoing peripheral revascularization. The evidence concerning patients with concomitant atrial fibrillation appears to be insufficient, however, recent guidelines propose the use of novel oral anticoagulants. Conclusion: For the time being, novel oral anticoagulants in combination with aspirin may provide an alternative treatment in PAD, however, it is deemed necessary to identify patient subgroups who will benefit the most.

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