Efficacy and Safety of Edoxaban in Anticoagulant Therapy Early After Surgical Bioprosthetic Valve Replacement: Rationale and Design of the ENBALV Trial.

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Chisato Izumi, Masashi Amano, Satsuki Fukushima, Hitoshi Yaku, Kiyoyuki Eishi, Taichi Sakaguchi, Manabu Minami, Haruko Yamamoto, Kaori Onda, Katsuhiro Omae
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引用次数: 0

Abstract

Background and purpose: Anticoagulant therapy with vitamin K antagonists is recommended within 3 to 6 months after bioprosthetic valve replacement to prevent thromboembolic events. However, data regarding whether direct oral anticoagulants can be an alternative to warfarin in such patients are limited. The purpose of this study is to compare the efficacy and safety of edoxaban versus warfarin within 3 months after bioprosthetic valve replacement.

Methods: The ENBALV trial is an investigator-initiated, phase 3, randomized, open-label, multicenter study. It involves patients aged 18 to 85 years undergoing bioprosthetic valve replacement at the aortic and/or mitral position. They are randomized 1:1 to receive either edoxaban or warfarin. Administration of edoxaban or warfarin is to be continued for 12 weeks after surgery. The primary outcome is the occurrence rate of stroke or systemic embolism at 12 weeks after surgery. The net clinical outcome is a composite of stroke, systemic embolism, or major bleeding, which is included in the secondary outcomes.

Conclusion: The ENBALV trial demonstrates the efficacy and safety of edoxaban compared with warfarin in patients early after bioprosthetic valve replacement, including patients with sinus rhythm, which will bring a significant benefit to patients in clinical practice.

Trial registration: Japan Registry of Clinical Trials (jRCT) 2051210209. 30 Mar 2022 https://jrct.niph.go.jp/latest-detail/jRCT2051210209 .

Abstract Image

埃多沙班在生物瓣膜置换术后早期抗凝治疗中的有效性和安全性:ENBALV试验的原理与设计。
背景和目的:建议在生物假体瓣膜置换术后 3 至 6 个月内使用维生素 K 拮抗剂进行抗凝治疗,以预防血栓栓塞事件的发生。然而,有关直接口服抗凝剂能否替代华法林治疗此类患者的数据十分有限。本研究旨在比较生物瓣膜置换术后3个月内依多沙班与华法林的疗效和安全性:ENBALV试验是一项由研究者发起的三期、随机、开放标签、多中心研究。接受主动脉和/或二尖瓣位置生物人工瓣膜置换术的患者年龄在 18 至 85 岁之间。患者按 1:1 随机分配接受依多沙班或华法林治疗。埃多沙班或华法林会在术后持续服用 12 周。主要结果是术后12周的中风或全身性栓塞发生率。净临床结果是中风、全身性栓塞或大出血的综合结果,这包括在次要结果中:ENBALV试验表明,与华法林相比,依多沙班对生物瓣膜置换术后早期患者(包括窦性心律患者)具有疗效和安全性,这将在临床实践中为患者带来显著益处:试验注册:日本临床试验注册中心(JRCT)2051210209。2022 年 3 月 30 日 https://jrct.niph.go.jp/latest-detail/jRCT2051210209 。
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来源期刊
Cardiovascular Drugs and Therapy
Cardiovascular Drugs and Therapy 医学-心血管系统
CiteScore
8.30
自引率
0.00%
发文量
110
审稿时长
4.5 months
期刊介绍: Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.
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