September 27, 2011Annals of Pharmacotherapy
The Role of Apixaban for Venous and Arterial Thromboembolic Disease
Key result
Apixaban outperforms warfarin for stroke and systemic embolism prevention in AF with less major bleeding.
Why the study?
Does apixaban improve thromboembolic outcomes compared to standard therapies in patients with atrial fibrillation, acute coronary syndrome, or undergoing orthopedic surgery?
Structured PICO
Does apixaban improve thromboembolic outcomes compared to standard therapies in patients with atrial fibrillation, acute coronary syndrome, or undergoing orthopedic surgery?
P
Population
Patients with atrial fibrillation, acute coronary syndrome, or undergoing orthopedic surgery (total hip or knee replacement)
I
Intervention
Apixaban
C
Comparator
Aspirin, warfarin, or enoxaparin
O
Outcome
Stroke and systemic embolism prevention, venous thromboembolism prophylaxis, and major bleeding
Apixaban is an effective alternative to warfarin for stroke prevention in atrial fibrillation and for VTE prophylaxis in orthopedic surgery, though its use in acute coronary syndrome is limited by bleeding risk.
Authors
Discussion
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Implication
May support apixaban preference in AF; leaves open optimal use in ACS and orthopedic settings.
Cite This Study
Prom et al. (2011) conducted a review in Venous and Arterial Thromboembolic Disease. Apixaban vs. Aspirin, warfarin, enoxaparin was evaluated. Apixaban is superior to warfarin for stroke and systemic embolism prophylaxis in patients with atrial fibrillation, with lower rates of major bleeding.