May 19, 2024Journal of the American College of Cardiology60 citationsOpen Access
Apixaban vs Aspirin According to CHA2DS2-VASc Score in Subclinical Atrial Fibrillation
Structured PICO
Does apixaban prevent stroke/SE compared to aspirin in patients with subclinical atrial fibrillation across different CHA2DS2-VASc scores?
P
Population
Patients with device-detected sub-clinical atrial fibrillation (ARTESiA trial cohort)
I
Intervention
Apixaban
C
Comparator
Aspirin
O
Outcome
Stroke/SE (systemic embolism)hard clinical
In patients with subclinical atrial fibrillation, the net clinical benefit of apixaban over aspirin for stroke prevention is highly dependent on baseline stroke risk, favoring apixaban only in those with a CHA2DS2-VASc score >4.
Abstract
One in 4 patients in ARTESiA with subclinical atrial fibrillation had a CHA2DS2-VASc score >4 and a stroke/SE risk of 2.2% per year. For these patients, the benefits of treatment with apixaban in preventing stroke/SE are greater than the risks. The opposite is true for patients with CHA2DS2-VASc score 2DS2-VASc =4) exists in which patient preferences will inform treatment decisions. (Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation; NCT01938248).
Cite This Study
Lópes et al. (Sun,) studied this question.