ACTIVE W
ACTIVE W is the acronym of a clinical study ( English Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events ) on the effectiveness of various drugs for the prevention of stroke and other emboli in patients with atrial fibrillation . The study was terminated prematurely because of the superior effectiveness of coumarin preparations compared to a combination of acetylsalicylic acid (ASA) and clopidogrel .
Course of studies
In a total of 6706 patients with atrial fibrillation and at least one other risk factor for a stroke (age at least 75 years, high blood pressure , previous embolism or stroke, TIA , arterial occlusive disease , ejection fraction below 45% or age 55–74 years in combination with diabetes mellitus or coronary disease Heart disease ) were randomly treated with either a coumarin preparation (target INR 2.0 to 3.0) or a combination of 75 mg clopidogrel and 75–100 mg ASA.
Results
After the study was terminated prematurely, the primary endpoint (stroke, embolism, myocardial infarction or death from a vascular cause) occurred 165 times with coumarin preparations and 234 times with ASA / clopidogrel. The difference between the calculated annual event rates of 3.93 and 5.60% was statistically highly significant (p = 0.0003). Serious bleeding was equally frequent in the treatment groups, while light bleeding occurred significantly more frequently with coumarins (568 versus 481 events, p = 0.0009).
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- ↑ ACTIVE Writing Group on behalf of the ACTIVE Investigators: Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomized controlled trial . Lancet (2006) 367: 1903-1912. PMID 16765759 .