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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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{blacktriangledown} Apixaban and {blacktriangledown} rivaroxaban for stroke prevention in AF

    Drug and Therapeutics Bulletin
    |January 10, 2014
    PubMed

    Insights

    Newer oral anticoagulants like apixaban and rivaroxaban are now available for preventing stroke in non-valvular atrial fibrillation (AF) patients. This review examines their evidence, considering risks like serious hemorrhage.

    Area of Science:

    • Pharmacology
    • Cardiology
    • Clinical Medicine

    Background:

    • Dabigatran was the first novel oral anticoagulant for stroke prevention in non-valvular atrial fibrillation (AF).
    • Its use has increased, with apixaban and rivaroxaban also licensed for this indication.
    • Drug safety alerts have noted risks of serious hemorrhage with these anticoagulants.

    Purpose of the Study:

    • To review the evidence for apixaban and rivaroxaban.
    • To assess their efficacy in preventing stroke and systemic embolism in adult patients with non-valvular AF.

    Main Methods:

    • Literature review of published evidence.
    • Analysis of clinical trial data and safety alerts.
    • Comparative assessment of new oral anticoagulants versus existing therapies.

    Main Results:

    • Apixaban and rivaroxaban are licensed alternatives to dabigatran for stroke prevention in AF.
    • Evidence supports their use in specific patient populations.
    • Risk of serious hemorrhage is a key consideration.

    Conclusions:

    • Apixaban and rivaroxaban represent important therapeutic options for stroke prevention in non-valvular AF.
    • Careful patient selection and monitoring are crucial due to bleeding risks.
    • These agents offer alternatives to warfarin and dabigatran, presenting challenges and opportunities for the NHS.

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