ACTIVE-Design article

《ACTIVE-Design article》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、RationaleanddesignofACTIVE:TheatrialfibrillationclopidogreltrialwithirbesartanforpreventionofvasculareventsTheACTIVESteeringCommitteeonbehalfoftheACTIVEInvestigatorsHamilton,Ontario,CanadaBackgroundAtrialfibrillation(AF)isthemostfrequentlyoccurringcardiacarrhythmiawitho

2、ftenseriousclinicalconsequences.Manypatientshavecontraindicationstoanticoagulation,anditisoftenunderusedinclinicalpractice.Theadditionofclopidogreltoaspirin(ASA)hasbeenshowntoreducevasculareventsinanumberofhigh-riskpopulations.Irbesartanisanangiotensinreceptor–blockinga

3、gentthatreducesbloodpressureandhasothervascularprotectiveeffects.MethodsandResultsACTIVEWisanoninferioritytrialofclopidogrelplusASAversusoralanticoagulationinpatientswithAFandatleast1riskfactorforstroke.ACTIVEAisadouble-blind,placebo-controlledtrialofclopidogrelinpatien

4、tswithAFandwithatleast1riskfactorforstrokewhoreceiveASAbecausetheyhaveacontraindicationfororalanticoagulationorbecausetheyareunwillingtotakeanoralanticoagulant.ACTIVEIisapartialfactorial,double-blind,placebo-controlledtrialofirbesartaninpatientsparticipatinginACTIVEAorA

5、CTIVEW.Theprimaryoutcomesofthesestudiesarecompositesofvascularevents.Atotalof14000patientswillbeenrolledinthesetrials.ConclusionsACTIVEisthelargesttrialyetconductedinAF.Itsresultswillleadtoanewunderstandingoftheroleofcombinedantiplatelettherapyandtheroleofbloodpressurel

6、oweringwithanangiotensinIIreceptorblockerinpatientswithAF.(AmHeartJ2006;151:1187-93.)AtrialfibrillationandAntithrombotictherapyinAFcardiovasculareventsSixtrialsevaluatingwarfarinorotheroralanticoagu-Atrialfibrillation(AF)isthemostcommoncardiaclantshavereportedrelativeri

7、skreductionsinstrokebetween33%to78%.Ameta-analysisofthefirst5ofarrhythmiawithpotentialforseriousconsequences.It7thesetrialsconcludedthattherelativeriskofstrokeaffectsN1%ofthepopulationandiscommoninthewassignificantlyreducedby67%andtheriskoftotalelderly.Inthoseolderthan7

8、5years,itsprevalenceisN10%.1OneoftheseriousoutcomesassociatedwithAFvasculareventswassignificantlyreducedby42%,