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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Edoxaban for the prevention of stroke in patients with atrial fibrillation

Carlos Escobar Cervantes1, José Luis Merino1, Vivencio Barrios2

  • 1a Cardiology Service, Unidad de electrofisiología cardíaca robotizada , Hospital Universitario La Paz , Madrid , Spain.

Expert Review of Cardiovascular Therapy
|March 23, 2019
PubMed

Insights

Edoxaban is a direct oral anticoagulant proven effective in preventing stroke in nonvalvular atrial fibrillation (AF) patients. It demonstrates non-inferiority to warfarin with a significant reduction in bleeding events and cardiovascular mortality.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis

Background:

  • Edoxaban is a recently marketed direct oral anticoagulant for stroke prevention in nonvalvular atrial fibrillation (AF).
  • The ENGAGE AF-TIMI 48 trial was pivotal for edoxaban's approval, with subsequent numerous substudies and real-world data emerging.
  • This review synthesizes current evidence on edoxaban's use in AF patients.

Purpose of the Study:

  • To provide an updated review of the efficacy and safety of edoxaban in patients with atrial fibrillation.
  • To consolidate findings from the pivotal ENGAGE AF-TIMI 48 trial and subsequent real-world evidence.

Main Methods:

  • Review of the pivotal ENGAGE AF-TIMI 48 clinical trial data.
  • Analysis of published substudies, post hoc analyses, and observational studies.
  • Synthesis of real-world data on edoxaban effectiveness and safety in AF patients.

Main Results:

  • Edoxaban 60 mg was non-inferior to warfarin for preventing stroke or systemic embolism in AF patients.
  • Edoxaban significantly reduced the risk of bleeding, major adverse cardiac events, and cardiovascular death compared to warfarin.
  • Efficacy and safety were consistent across various patient subgroups and clinical conditions.

Conclusions:

  • Edoxaban is a safe and effective alternative to warfarin for stroke prevention in nonvalvular AF.
  • Real-world data, though limited, align with clinical trial findings, supporting edoxaban's established profile.
  • Edoxaban presents a cost-effective option for AF patients at moderate to high risk of thromboembolism.
Abstract

Keywords:
Atrial fibrillationENGAGE AF–TIMI 48bleedingedoxabanstroke

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