Key result
Apixaban use was associated with a lower risk of ischaemic stroke or systemic thromboembolism compared with rivaroxaban (HR 0.85; 95% CI 0.74-0.99), and similar risks compared with dabigatran.
Why the study?
There are conflicting signals in the literature regarding the comparative safety and effectiveness of DOACs for nonvalvular atrial fibrillation.
Does the choice of direct oral anticoagulant (apixaban, rivaroxaban, or dabigatran) affect the risk of stroke, systemic thromboembolism, and bleeding in adults with nonvalvular atrial fibrillation?
Cohort (n=227,579)
Yes
Does the choice of direct oral anticoagulant (apixaban, rivaroxaban, or dabigatran) affect the risk of stroke, systemic thromboembolism, and bleeding in adults with nonvalvular atrial fibrillation?
Hazard Ratio: 0.85 (95% CI 0.74–0.99)
In patients with nonvalvular atrial fibrillation, apixaban is associated with lower risks of stroke and bleeding compared with rivaroxaban, and similar risks compared with dabigatran.
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Supports preferring apixaban over rivaroxaban in nonvalvular AF; leaves open need for randomized confirmation.
Durand et al. (2020) conducted a cohort in Nonvalvular atrial fibrillation (n=227,579). Apixaban vs. Rivaroxaban was evaluated on ischaemic stroke or systemic thromboembolism (HR 0.85, 95% CI 0.74-0.99). Apixaban use was associated with a lower risk of ischaemic stroke or systemic thromboembolism compared with rivaroxaban (HR 0.85; 95% CI 0.74-0.99), and similar risks compared with dabigatran.
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