Key result
Apixaban was associated with a lower rate of systemic embolism or stroke compared to acenocoumarol in patients with nonvalvular atrial fibrillation (HR 0.54; 95% CI 0.38-0.78; p=0.001).
Why the study?
To compare the risk of stroke, systemic thromboembolism, and bleeding in patients initiating apixaban or acenocoumarol for nonvalvular atrial fibrillation.
Does apixaban reduce stroke, systemic thromboembolism, and bleeding compared to acenocoumarol in patients with nonvalvular atrial fibrillation?
Observational
Does apixaban reduce stroke, systemic thromboembolism, and bleeding compared to acenocoumarol in patients with nonvalvular atrial fibrillation?
Hazard Ratio: 0.54 (95% CI 0.38–0.78)
p-value: p=0.001
In a Spanish real-world cohort, apixaban was associated with significantly lower risks of stroke, systemic embolism, and bleeding compared to acenocoumarol in patients with nonvalvular atrial fibrillation.
Apixaban was associated with lower risks in this cohort; leaves open randomized confirmation of superiority over acenocoumarol.
Aim: To compare the risk of stroke, systemic thromboembolism and bleeding, in patients initiating apixaban or acenocoumarol for the treatment of nonvalvular atrial fibrillation. Methods: An observational, retrospective study was performed using medical records of patients who initiated apixaban or acenocoumarol between 2015 and 2017. Propensity score matching was used to match patients; stroke, systemic thromboembolism, major and minor bleeding events were compared between the matched patients. Results: Patients who were prescribed apixaban had a lower rate of systemic embolism/stroke (hazard ratio [HR] = 0.54; 95% CI: 0.38–0.78; p = 0.001), minor bleeding (HR = 0.64; 95% CI: 0.52–0.79; p < 0.001) and major bleeding (HR = 0.51; 95% CI: 0.37–0.72; p < 0.001). Conclusion: Patients prescribed apixaban for the treatment of nonvalvular atrial fibrillation had lower rates of thromboembolic events and minor/major bleeding than patients on acenocoumarol.
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Ramagopalan et al. (2019) conducted an observational in nonvalvular atrial fibrillation. Apixaban vs. Acenocoumarol was evaluated on systemic embolism/stroke (HR 0.54, 95% CI 0.38-0.78, p=0.001). Apixaban was associated with a lower rate of systemic embolism or stroke compared to acenocoumarol in patients with nonvalvular atrial fibrillation (HR 0.54; 95% CI 0.38-0.78; p=0.001).
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