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Updated: Feb 13, 2026
08:10
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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Initial apixaban dosing in patients with atrial fibrillation
Alexander Buchholz1, Laura Ueberham1, Kaja Gorczynska1
1Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany.
Clinical Cardiology
|March 16, 2018
Summary
Apixaban dosing in clinical practice often deviates from labeling, with age, weight, and creatinine levels incorrectly influencing dose reductions. This leads to inappropriate underdosing in many nonvalvular atrial fibrillation patients.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Practice
Background:
- Apixaban is a key anticoagulant for nonvalvular atrial fibrillation (AF) patients.
- Current guidelines recommend apixaban dose reduction based on age, weight, and renal function.
Purpose of the Study:
- To evaluate adherence to apixaban dosing guidelines in clinical practice.
- To identify factors contributing to inappropriate dose reductions.
Main Methods:
- Retrospective analysis of 569 AF patients initiated on apixaban in 2016.
- Assessment of prescribed dose, patient characteristics, renal function, and co-medications.
Main Results:
- Over half of patients (47.1%) received a reduced apixaban dose.
- A significant proportion (60.8%) of those on reduced doses did not meet guideline criteria.
- Age, weight, and serum creatinine were independent predictors of underdosage.
Conclusions:
- Apixaban dosing in clinical practice frequently contradicts labeling recommendations.
- Inappropriate dose reductions are linked to age, weight, and creatinine levels.
- Underdosed patients often did not meet the criteria for dose adjustment.
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