Key result
A review of the literature indicates that apixaban is associated with a lower rate of intracranial hemorrhages and fewer adverse consequences following extracranial hemorrhage compared with warfarin.
Why the study?
What are the risks and management strategies for extracranial and intracranial bleeding associated with apixaban compared to warfarin?
What are the risks and management strategies for extracranial and intracranial bleeding associated with apixaban compared to warfarin?
This review highlights that while apixaban has a lower risk of intracranial hemorrhage compared to warfarin, prolonged use increases bleeding risk, necessitating careful management.
Answers are grounded in this paper and cite their sources.
May favor apixaban over warfarin in high-bleed-risk patients; leaves open need for prospective confirmation.
Apixaban is a new oral anticoagulant (NOACs: Novel Oral Anticoagulant), like dabigatran, rivaroxaban, and edoxaban. All of them are prescribed to patients with non valvular atrial fibrillation or venous thromboembolism, to replace warfarin, because of the lower probability of bleeding, however they can cause bleeding by themselves. Bleeding is an adverse event in patients taking anticoagulants. It is associated with a significant increase of morbidity and risk of death. However, these drugs should be used only for the time when anticoagulation is strictly required, especially when used for preventing deep vein thrombosis. Prolonged use increases the risk of bleeding. In the ARISTOTLE Trial Apixaban, compared with warfarin, was associated with a lower rate of intracranial hemorrhages and less adverse consequences following extracranial hemorrhage. Many physicians still have limited experience with new oral anticoagulants and about bleeding risk managment. We reviewed the available literature on extracranial and intracranial bleeding concerning apixaban.
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Ciccone et al. (2015) conducted a review in Non valvular atrial fibrillation or venous thromboembolism. Apixaban vs. Warfarin was evaluated on Extracranial and intracranial bleeding. A review of the literature indicates that apixaban is associated with a lower rate of intracranial hemorrhages and fewer adverse consequences following extracranial hemorrhage compared with warfarin.
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