In patients with atrial fibrillation who were unable to receive warfarin for any reason, the use of apixaban reduced the risk of stroke and systemic embolism when compared to aspirin. Study Rundown: Atrial fibrillation is a common arrhythmia that increases the risk of stroke and. AVERROES has shown that the new oral anti-Xa inhibitor apixaban is superior to aspirin in terms of efficacy, with surprisingly similar safety. AVERROES. Apixaban Versus ASA. To Reduce the Risk Of Stroke. Coordinated by Population Health Research institute. Hamilton, Ontario, Canada. Sponsors.
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Also, how apicaban apixaban compare to aspirin rates of major bleeding? Dual therapy decreased rates of major vascular events at cost of increased major bleeding.
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The AVERROES Trial – Clinical Implications
In patients with atrial fibrillation thought to be unsuitable candidates for anticoagulation with a vitamin K antagonist, apixaban signficantly reduced the risk of stroke and systemic embolism without increasing the risk of major bleeding or intracranial hemorrhage when compared aaverroes aspirin. The reasons that VKA therapy was unsuitable for the patient had to be documented in the study case report forms.
Concurrent medications that could alter activity of VKAs; 8. Apixaban is a novel oral anticoagulant that inhibits factor Xa.
This page was last modified on 3 Decemberat The New England Journal of Medicine. Its role in prevention of stroke in patients unsuitable for VKA therapy, but maintained on aspirin therapy, was unknown.
There were 11 intracranial bleeds on apixaban and 13 on aspirin apixaban 1. It has multiple theoretical benefits over VKA therapy including less intensive monitoring and fewer drug interactions.
Usable articles Cardiology Neurology. Concurrent medications whose metabolism could be affected by VKAs; 9. In such patients, aspirin plus clopidogrel reduced the rate of major vascular events, in particular stroke, vs.
AVERROES – Wiki Journal Club
Connolly SJ, et al. We will here briefly discuss the clinical implications of the trial. The primary outcome was stroke or systemic embolism.
Apixaban is, at the time of writing, the best alternative to aspirin in patients deemed unsuitable for vitamin K antagonists. Dabigatran versus warfarin in patients with atrial fibrillation. With a mean follow-up of 1. Presented as apixaban vs. Read your latest personalised notifications Sign in No account yet?
VKA therapy not recommended by the physician; Thus, a clear superiority of apixaban over aspirin was shown in terms of efficacy, with comparable safety. Guidelines for the management of atrial fibrillation: There were 51 primary outcome events in those randomised to apixaban 1. To get the best experience using our website we recommend that you upgrade to a newer version.
Assessment that patient would be unable or unlikely to adhere to restrictions on factors such as alcohol and diet; Assessment that INR could not or was unlikely to be measured at requested interval; 5.
Eur Heart J ; Views Read View source View history. Based on the indirect comparison with ACTIVE A, one should conclude that apixaban is, at the time of writing, the best alternative to aspirin ever found in patients deemed unsuitable for VKAs.
Analyses are to time of first event. In addition, patients could not be receiving VKA therapy, either because it had been demonstrated unsuitable in their case or because it was expected to be unsuitable.
The AVERROES Trial – Clinical Implications
In April the Data and Safety Monitoring Board recommended early study termination because of clear benefit in favor of apixaban. Strengths Strong points and important messages of the study are: Of the patients enrolled, reasons for being deemed unsuitable for VKA therapy included the following: Apixaban in Patients with Atrial Fibrillation.
Other characteristics indicating risk of stroke too low to warrant treatment with VKAs; Did you know averrose your browser is out of date? One may question each of these choices: Patients were eligible if they were 50 years of age or older and if they had atrial fibrillation that had been documented in the 6 months prior to enrollment or by lead electrocardiography on the day of screening. J Am Coll Cardiol ; Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation.