ORal anticoaGulants in diAbetic and Nondiabetic patients with nOn-valvular atrial fibrillatioN (ORGANON)
Copyright © 2023 Elsevier Inc. All rights reserved..
BACKGROUND: Diabetes represents a pro-thrombotic condition.
OBJECTIVES: The primary objective was to evaluate the effects of Vitamin K Antagonist (VKA) compared to direct oral anticoagulants (DOACs) in diabetic and nondiabetic patients with non-valvular atrial fibrillation, newly diagnosed. The secondary objective was to evaluate the effects on the risk of bleeding.
METHODS: We enrolled 300 patients with newly diagnosed atrial fibrillation. One hundred and sixteen patients were taking warfarin, 31 acenocumarol, 22 dabigatran, 80 rivaroxaban, 34 apixaban, and 17 edoxaban. We evaluated: anthropometric parameters, glycated hemoglobin (HbA1c), fasting and post-prandial glucose (FPG, and PPG), lipid profile, Lp(a), small and dense low-density lipoprotein (SD-LDL), oxidized LDL (Ox-LDL), I-troponin (I-Tn), creatinine, transaminases, iron, red blood cells (RBC); hemoglobin (Hb), platelets (PLT), fibrinogen, D-dimer, anti-thrombin III, C-reactive protein (Hs-CRP), Metalloproteinases-2 (MMP-2), Metalloproteinases-9 (MMP-9), and incidence of bleeding.
RESULTS: We did not record any differences among nondiabetic patients between VKA and DOACs. However, when we considered diabetic patients, we found a slight, but significant improvement of triglycerides and SD-LDL. As regards incidence of bleeding, minor bleeding was more frequent in VKA diabetic group compared to DOACs diabetic group; furthermore, the incidence of major bleeding was higher with VKA in nondiabetic and diabetic group, compared to patients with DOACs. Among DOACs, we recorded a higher incidence of bleeding (minor and major) with dabigatran compared to rivaroxaban, apixaban and edoxaban in nondiabetic and diabetic patients.
CONCLUSION: DOACs seem to be metabolically favourable in diabetic patients. Regarding incidence of bleeding, DOACs with the exception of dabigatran, seem better than VKA in diabetic patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Journal of diabetes and its complications - 37(2023), 8 vom: 01. Aug., Seite 108512 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Derosa, Giuseppe [VerfasserIn] |
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| Links: |
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| Themen: |
9NDF7JZ4M3 |
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| Anmerkungen: |
Date Completed 11.08.2023 Date Revised 11.08.2023 published: Print-Electronic ClinicalTrials.gov: NCT02935855 Citation Status MEDLINE |
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| doi: |
10.1016/j.jdiacomp.2023.108512 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358920485 |
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| 100 | 1 | |a Derosa, Giuseppe |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a ORal anticoaGulants in diAbetic and Nondiabetic patients with nOn-valvular atrial fibrillatioN (ORGANON) |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.08.2023 | ||
| 500 | |a Date Revised 11.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT02935855 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Diabetes represents a pro-thrombotic condition | ||
| 520 | |a OBJECTIVES: The primary objective was to evaluate the effects of Vitamin K Antagonist (VKA) compared to direct oral anticoagulants (DOACs) in diabetic and nondiabetic patients with non-valvular atrial fibrillation, newly diagnosed. The secondary objective was to evaluate the effects on the risk of bleeding | ||
| 520 | |a METHODS: We enrolled 300 patients with newly diagnosed atrial fibrillation. One hundred and sixteen patients were taking warfarin, 31 acenocumarol, 22 dabigatran, 80 rivaroxaban, 34 apixaban, and 17 edoxaban. We evaluated: anthropometric parameters, glycated hemoglobin (HbA1c), fasting and post-prandial glucose (FPG, and PPG), lipid profile, Lp(a), small and dense low-density lipoprotein (SD-LDL), oxidized LDL (Ox-LDL), I-troponin (I-Tn), creatinine, transaminases, iron, red blood cells (RBC); hemoglobin (Hb), platelets (PLT), fibrinogen, D-dimer, anti-thrombin III, C-reactive protein (Hs-CRP), Metalloproteinases-2 (MMP-2), Metalloproteinases-9 (MMP-9), and incidence of bleeding | ||
| 520 | |a RESULTS: We did not record any differences among nondiabetic patients between VKA and DOACs. However, when we considered diabetic patients, we found a slight, but significant improvement of triglycerides and SD-LDL. As regards incidence of bleeding, minor bleeding was more frequent in VKA diabetic group compared to DOACs diabetic group; furthermore, the incidence of major bleeding was higher with VKA in nondiabetic and diabetic group, compared to patients with DOACs. Among DOACs, we recorded a higher incidence of bleeding (minor and major) with dabigatran compared to rivaroxaban, apixaban and edoxaban in nondiabetic and diabetic patients | ||
| 520 | |a CONCLUSION: DOACs seem to be metabolically favourable in diabetic patients. Regarding incidence of bleeding, DOACs with the exception of dabigatran, seem better than VKA in diabetic patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a DOACs | |
| 650 | 4 | |a Diabetes | |
| 650 | 4 | |a Metabolic parameters | |
| 650 | 4 | |a Warfarin | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Dabigatran |2 NLM | |
| 650 | 7 | |a I0VM4M70GC |2 NLM | |
| 650 | 7 | |a edoxaban |2 NLM | |
| 650 | 7 | |a NDU3J18APO |2 NLM | |
| 650 | 7 | |a Rivaroxaban |2 NLM | |
| 650 | 7 | |a 9NDF7JZ4M3 |2 NLM | |
| 700 | 1 | |a Rizzo, Manfredi |e verfasserin |4 aut | |
| 700 | 1 | |a Brunetti, Natale Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Raddino, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Gavazzoni, Mara |e verfasserin |4 aut | |
| 700 | 1 | |a Pasini, Gianfranco |e verfasserin |4 aut | |
| 700 | 1 | |a Gaudio, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Maggi, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a D'Angelo, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a De Gennaro, Luisa |e verfasserin |4 aut | |
| 700 | 1 | |a Maffioli, Pamela |e verfasserin |4 aut | |
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