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Electrophysiology, general cardiology, heart failure
Apixaban shows safety in secondary analysis
The decision to anticoagulate a patient with atrial fibrillation involves a balance between the risks of thromboembolism against those of haemorrhage, with both risks imperfectly predicted by even the best stratification scoring systems. Although warfarin reduces the risk of stroke in patients with atrial fibrillation, its use remains limited by several limitations. Apixaban is a novel direct factor Xa inhibitor, previously found to be superior to warfarin at prevention of stroke or systemic embolism in the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial.
Lopes et al attempted to determine how the results of anticoagulation with apixiban differed depending on the patients’ baseline risk of ischaemic events (CHADS2 and CHA2DS2-VASc) and bleeding (HAS-BLED) and found that apixaban consistently outperformed warfarin in terms of reducing the risk of clinical events (stroke, bleeding, and mortality) irrespective of CHADS2, CHA2DS2-VASc or HAS-BLED score. In addition, Apixaban …