The results of the RE- LY study promise more effective, safer and easier prevention of embolic complications in patients with non‑valvular atrial fibrillation

Czech version

Authors: J. Vojáček
Authors‘ workplace: I. interní klinika Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MU Dr. Jan Vojáček, DrSc., FESC, FACC
Published in: Vnitř Lék 2009; 55(11): 1085-1088
Category: Reviews

Overview

The RE-LY study compared dabigatran in the dose of 150 mg and 110 mg twice daily, without laboratory monitoring, with the conventional treatment with warfarin dosed according to INR in 18,113 patients with non‑valvular atrial fibrillation and high risk of embolisation. The incidence of cerebrovascular events and systemic embolisation was 1.69% per year in the warfarin group, compared to 1.53% per year in the 110 mg dabigatran group (relative risk 0.91; 95% CI 0.74 –⁠ 1.11; p

Key words:
non‑valvular atrial fibrillation –⁠ dabigatran –⁠ warfarin –⁠ cerebrovascular event –⁠ systemic embolisation

Sources

1. Ezekowitz MD, Connolly S, Parekh A et al. Rationale and design of RE ‑⁠ LY: randomized evaluation of long‑term anticoagulant therapy, warfarin, compared with dabigatran. Am Heart J 2009; 157 : 805 –⁠ 810.

2. Greenlee RT, Vidaillet H. Recent progress in the epidemiology of atrial fibrillation. Review. Curr Opin Cardiol 2005; 20 : 7 –⁠ 14.

3. Go AS. The epidemiology of atrial fibrillation in elderly persons: the tip of the iceberg. Am J Geriatr Cardiol 2005; 14 : 56 –⁠ 61.

4. Hart RG, Pearce LA, Aguilar MI. Meta‑analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146 : 857 –⁠ 867.

5. Fuster V, Rydén LE, Cannom DS et al. ACC/ AHA/ ESC 2006 guidelines for the management of patients with atrial fibrillation: full text A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Europace 2006; 8 : 651 –⁠ 745.

6. van Walraven C, Hart RG, Wells GA et al. A clinical prediction rule to identify patients with atrial fibrillation and a low risk for stroke while taking aspirin. Arch Intern Med 2003; 163 : 936 –⁠ 943.

7. Connolly S, Pogue J, Hart R et al. ACTIVE Investigators. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006; 367 : 1903 –⁠ 1912.

8. Connolly SJ, Pogue J, Hart RG et al. ACTIVE Investigators. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 2009; 360 : 2066 –⁠ 2078.

9. Connolly S, Ezekowitz MD, Yusuf S et al. RE ‑⁠ LY Steering Committee and Investigators. Dabigatran versus Warfarin in Patients with Atrial Fibrillation. N Engl J Med 2009; 361 : 1139 –⁠ 1151.

10. Gage BF. Can We Rely on RE ‑⁠ LY? N Engl J Med 2009; 361 : 1200 –⁠ 1202.