Key result
Apixaban and rivaroxaban show similar ischemic stroke rates in NVAF patients with BMI ≥50 versus 18-30.
Why the study?
Apixaban and rivaroxaban are increasingly used for thromboembolism prophylaxis in patients with NVAF and BMI ≥50 kg/m2 despite limited data.
Are apixaban and rivaroxaban effective and safe for thromboembolism prophylaxis in patients with non-valvular atrial fibrillation and BMI ≥50 kg/m² compared to those with BMI 18-30 kg/m²?
Cohort (n=595)
No
Are apixaban and rivaroxaban effective and safe for thromboembolism prophylaxis in patients with non-valvular atrial fibrillation and BMI ≥50 kg/m² compared to those with BMI 18-30 kg/m²?
Effect estimate: RR 0.65 (95% CI 0.38-1.82)
Absolute Event Rate: 1.3% vs 2%
p-value: p=0.544
Apixaban and rivaroxaban appear to be safe and effective for stroke prevention in patients with non-valvular atrial fibrillation and extreme obesity (BMI ≥50 kg/m²), with similar outcomes to non-obese patients.
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May support use in extreme obesity; hypothesis-generating and should not yet change practice.
O’Kane et al. (2021) conducted a cohort in non-valvular atrial fibrillation (NVAF) (n=595). Apixaban and rivaroxaban vs. Patients with BMI 18 to 30 kg/m2 was evaluated on incidence of ischemic stroke (RR 0.65, 95% CI 0.38-1.82, p=0.544). Apixaban and rivaroxaban in NVAF patients with BMI ≥50 kg/m2 showed similar ischemic stroke rates compared to those with BMI 18-30 kg/m2 (1.3 vs 2.0 per 100 patient-years; RR 0.65; P=0.544).
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