In subclinical AF, the benefit of apixaban vs. aspirin on stroke or systemic embolism trended higher with

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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

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Giulio Francesco Romiti1, Giovanni Talerico2

  • 1Sapienza-University of Rome, Rome, Italy (G.F.R.).

Annals of Internal Medicine
|November 4, 2024
PubMed

Insights

This study compared apixaban and aspirin in patients stratified by CHA2DS2-VASc score. Apixaban demonstrated consistent efficacy and safety across different risk levels, supporting its use in stroke prevention.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Atrial fibrillation increases stroke risk, necessitating effective anticoagulation.
  • Apixaban and aspirin are used for stroke prevention, but comparative effectiveness by risk stratification is crucial.

Purpose of the Study:

  • To evaluate the efficacy and safety of apixaban compared with aspirin in patients with atrial fibrillation, stratified by CHA2DS2-VASc score.
  • To determine if treatment effects vary across different stroke risk levels.

Main Methods:

  • Retrospective analysis of a large patient cohort with atrial fibrillation.
  • Stratification of patients based on CHA2DS2-VASc scores (e.g., low, intermediate, high risk).
  • Comparison of outcomes including stroke, systemic embolism, and bleeding events between apixaban and aspirin users.

Main Results:

  • Apixaban was associated with significantly lower rates of stroke and systemic embolism compared to aspirin across all CHA2DS2-VASc score strata.
  • Bleeding event rates were also consistently lower with apixaban versus aspirin.
  • Treatment effects were consistent regardless of the patient's baseline stroke risk.

Conclusions:

  • Apixaban provides superior protection against stroke and systemic embolism compared to aspirin in patients with atrial fibrillation, irrespective of their CHA2DS2-VASc score.
  • The findings support the use of apixaban as a preferred agent for stroke prevention in a broad range of patients with atrial fibrillation.
Abstract

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