Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase

Huan Wang; Xiao-kai Zhou; Li-fan Zheng; Xiao-ying Wu; Hui Chen

doi:10.1007/s11655-015-2443-4

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Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase

OriginalPaper | Updated：2021-08-27

- Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase
- Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase
- 中国结合医学杂志（英文版） 2018年24卷第4期页码：247-253
- Affiliations：
  
  1. Department of Internal Medicine, Fujian Provincial Cardiovascular Disease Institute, Provincial Clinical College of Fujian Medical University,Fuzhou,China
  2. Cardiovascular Internal Medicine, Quzhou People’s Hospital of Zhejiang Province,Zhejiang Province,Quzhou,China
  3. Cardiovascular Internal Medicine, the Affiliated Hospital in Putian College of Fujian Province,Fujian Province,Putian,China
- Author bio：
- Funds：
- DOI：10.1007/s11655-015-2443-4
  中图分类号：
- 纸质出版日期：2018，
  
  网络出版日期：2016-2-26，
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Wang, H., Zhou, Xk., Zheng, Lf. et al. Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase., Chin. J. Integr. Med. 24, 247–253 (2018). https://doi.org/10.1007/s11655-015-2443-4

Huan Wang, Xiao-kai Zhou, Li-fan Zheng, et al. Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase[J]. Chinese Journal of Integrative Medicine, 2018,24(4):247-253.
Wang, H., Zhou, Xk., Zheng, Lf. et al. Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase., Chin. J. Integr. Med. 24, 247–253 (2018). https://doi.org/10.1007/s11655-015-2443-4 DOI：

Huan Wang, Xiao-kai Zhou, Li-fan Zheng, et al. Comparison of Aspirin and Naoxintong Capsule (脑心通胶囊) with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase[J]. Chinese Journal of Integrative Medicine, 2018,24(4):247-253. DOI： 10.1007/s11655-015-2443-4.

摘要

To compared the therapeutic effect of a Chinese patent medicine Naoxintong Capsule (脑心通胶囊

NXT) and aspirin with adjusted-dose warfarin in Chinese elderly patients (over 65 years) with nonvalvular atrial fibrillation (NVAF) and genetic variants of vitamin K epoxide reductase (VKORC1)

who are at high-risk of thromboembolism. A total of 151 patients

with NVAF and AA genotype of VKORC1-1639 (a sensitive genotype to warfarin) and a CHA2DS2-VASc clinical risk score of 2 or above

were chosen for this study. Patients were randomized into two groups and orally treated with a combination of aspirin (100 mg/day) and NXT (1.6 g thrice a day) or adjusted-dose warfarin [international normalized ratio 2.0–3.0). The primary end points including ischemic stroke and death as well as the secondary end points including hemorrhage events were followed up for at least 1 year. Baseline clinical data and the rates of primary end points were similar between groups. However

the rate of serious bleeding (secondary event) in the combination therapy group was lower than that in the adjusted-dose warfarin group (0% vs. 7.9%

odds ratio: 0.921

95% confidence interval: 0.862–0.984

P=0.028). Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However

as compared with warfarin

the combination therapy reduced the rate of serious bleeding. Therefore

aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596)

Abstract

To compared the therapeutic effect of a Chinese patent medicine Naoxintong Capsule (脑心通胶囊

NXT) and aspirin with adjusted-dose warfarin in Chinese elderly patients (over 65 years) with nonvalvular atrial fibrillation (NVAF) and genetic variants of vitamin K epoxide reductase (VKORC1)

who are at high-risk of thromboembolism. A total of 151 patients

with NVAF and AA genotype of VKORC1-1639 (a sensitive genotype to warfarin) and a CHA2DS2-VASc clinical risk score of 2 or above

the rate of serious bleeding (secondary event) in the combination therapy group was lower than that in the adjusted-dose warfarin group (0% vs. 7.9%

odds ratio: 0.921

95% confidence interval: 0.862–0.984

P=0.028). Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However

as compared with warfarin

the combination therapy reduced the rate of serious bleeding. Therefore

aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596)

关键词

Atrial Fibrillationantithrombotic therapygenetic variantsWarfarinaspirin combined with NaoxintongChinese MedicineAlternative Medicine

Keywords

Atrial Fibrillationantithrombotic therapygenetic variantsWarfarinaspirin combined with NaoxintongChinese MedicineAlternative Medicine

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