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September 2, 2024European Heart JournalOpen Access

Anticoagulation in patients with device-detected atrial fibrillation showed a trend toward greater cardiovascular benefit in those with vascular disease compared to those without (p-interaction=0.08).

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Why the study?

Does anticoagulation reduce cardiovascular events in patients with device-detected atrial fibrillation with or without vascular disease?

Population

6,546 patients with device-detected atrial fibrillation with or without vascular disease from the NOAH-AFNET…

Comparison

Anticoagulation (edoxaban or apixaban) vs No anticoagulation

Design

Meta-analysis

Key result

Anticoagulation in patients with device-detected atrial fibrillation showed a trend toward greater cardiovascular benefit in those with vascular disease compared to those without (p-interaction=0.08).

Authors

RSRenate B. SchnabelJBJuan Benezet‐MazuecosNBNina Becher

Discussion

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Overview

Anticoagulation may reduce events more in DDAF with vascular disease than without; extends risk stratification for shared decisions in device-detected AF.

Study Design

Type

Meta-Analysis (n=6,546)

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does anticoagulation reduce cardiovascular events in patients with device-detected atrial fibrillation with or without vascular disease?

P
Population
6,546 patients with device-detected atrial fibrillation with or without vascular disease from the NOAH-AFNET 6 and ARTESiA trials.
I
Intervention
Anticoagulation (edoxaban or apixaban)
C
Comparator
No anticoagulation
O
Outcome
Composite of stroke, systemic arterial embolism (SE), myocardial infarction, pulmonary embolism or cardiovascular death, and stroke or SEcomposite

Main Result

p-value: p=0.08

Patients with device-detected atrial fibrillation and concomitant vascular disease may derive a greater benefit from anticoagulation compared to those without vascular disease, despite a similar relative increase in major bleeding.

Cite This Study

Schnabel et al. (2024) conducted a meta-analysis in Device-detected atrial fibrillation (n=6,546). Anticoagulation vs. No anticoagulation was evaluated on Composite of stroke, systemic arterial embolism, myocardial infarction, pulmonary embolism or cardiovascular death (p=0.08). Anticoagulation in patients with device-detected atrial fibrillation showed a trend toward greater cardiovascular benefit in those with vascular disease compared to those without (p-interaction=0.08).

synapsesocial.com/papers/6ab23ca436566efabda037echttps://doi.org/10.1093/eurheartj/ehae596
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of anticoagulation in patients with device-detected atrial fibrillation and multiple stroke risk factors: a win ratio analysis of the NOAH-AFNET 6 trial2025 · 4 citations
  2. 2Anticoagulation in Patients With Device‐Detected Atrial Fibrillation With and Without a Prior Stroke or Transient Ischemic Attack: The NOAH‐AFNET 6 Trial2024 · 30 citations
  3. 3Discrepant Outcomes of Direct Oral Anticoagulant Trials in Device-Detected Atrial Fibrillation after Stroke: Insights from NOAH-AFNET 6 and ARTESIA2026
  4. 4Anticoagulation in device-detected atrial fibrillation: Challenges in stroke prevention and heart failure management2025
  5. 5Recurrent stroke in patients with history of stroke/transient ischemic attack and device-detected atrial fibrillation: A systematic review and meta-analysis2025 · 4 citations