Insights from the RE-LY CHA2DS2VASc Subgroup Analysis
This study, led by Hisao Ogawa from Kumamoto University in Japan, analyzed data from the RE-LY trial to provide insights into the
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Slide1Insights of the RE-LY CHA 2 DS 2 -VASc subgroup analysis Hisao Ogawa Kumamoto University, Japan
Slide2CHA2 DS 2 -VASc Lip GY, et al., Chest 137, 263-272, 2010 maximum score is 9 since age may contrubute 0, 1, or 2 points
Slide3CHA2 DS 2 -VASc – overall event rates %/year CHA 2 DS 2 -VASc 0-1 634 2 3408 3 5365 4 4378 5 2566 6 1185 7 451 8-9 125 No of patients Stroke and systemic embolism 0 1 2 3 4 5 6
Slide4CHA2 DS 2 -VASc – overall event rates Major (including intracranial) bleeding CHA 2 DS 2 -VASc 0-1 634 2 3408 3 5365 4 4378 5 2566 6 1185 7 451 8-9 125 No of patients 0 1 2 3 4 5 6 7 8 %/year Major Intracranial
Slide5singer de, et al. : ann intern med. 151, 297-305, 2009Better with Warfarin -1 -0.5 0 0.5 1 1.5 2 2.5 3 3.5 Worse with Warfarin 4-6 3 2 1 0 CHADS 2 score 2.22 0.58 3.75 2.07 1.21 2.79 0.97 0.43 1.41 0.19 -0.27 0.45 -0.11 -0.44 -0.20 The Net Clinical Benefit of warfarin by CHADS 2 score
Slide6D110D150 Warfarin D110 BID vs. warfarin D150 BID vs. warfarin CHA 2 DS 2 -VASc 0.50 1.00 1.50 Dabigatran better Warfarin better Annual rate, % 0.50 1.00 1.50 Dabigatran better Warfarin better Stroke and systemic embolism (SE) ≤2 3 4 5-9 0.9 0.5 0.8 1.3 0.8 1.4 1.6 1.0 2.0 2.4 2.1 2.8 p(inter)=0.81 p(inter)=0.60
Slide70.501.00 1.50 Dabigatran better Warfarin better 0.50 1.00 1.50 Dabigatran better Warfarin better D110 BID vs. warfarin D150 BID vs. warfarin Intracranial bleeding D110 D150 Warfarin Annual rate, % ≤2 3 4 5-9 p(inter)=0.77 p(inter)=0.09 0.15 0.11 0.38 0.16 0.32 0.76 0.29 0.21 1.04 0.32 0.63 0.84 CHA 2 DS 2 -VASc
Slide8Conclusion Increasing CHA 2 DS 2 -VASc scores are associated with raised risks for stroke and bleeding, Irrespective of CHA 2 DS 2 -VASc scores dabigatran 150 mg was superior and dabigatran 110 mg non-inferior to warfarin for stroke prevention Both dabigatran doses reduce intracranial bleeding irrespective of CHA 2 DS 2 -VASc scores Dabigatran has a favorable benefit risk profile compared to warfarin in patients with low to high CHA 2 DS 2 -VASc scores
