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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Other characteristics indicating risk of stroke too low to warrant treatment with VKAs; Effect of clopidogrel added to aspirin in patients with atrial fibrillation. Aaverroes from ” http: Views Read View source View history.
Statistics presented where given by the authors.
It has multiple theoretical benefits over VKA therapy including averroea intensive monitoring and fewer drug interactions. Usable articles Cardiology Neurology. This page was last modified on 3 Decemberat Concurrent medications that could alter activity of VKAs; 8. In patients with atrial fibrillation thought to be unsuitable for anticoagulation with a vitamin K antagonist, does apixaban reduce risk for stroke or systemic embolism when compared to aspirin? There were 11 intracranial bleeds on apixaban and 13 on aspirin apixaban 1.
All these reasons can be grouped in three broad categories: The primary outcome was stroke or systemic embolism. There were 51 primary outcome events in those randomised to apixaban 1. The trial was terminated early given a treatment benefit with apixaban. Of the patients enrolled, reasons for being deemed unsuitable for VKA therapy included the following: Strengths Strong points and important messages of the study are: Concurrent medications whose metabolism could be affected by VKAs; 9.
Expected difficulty in contacting patient for urgent change in dose of VKAs; 6. Dabigatran versus warfarin in patients averros atrial fibrillation.
The AVERROES Trial – Clinical Implications
N Engl J Med ; Sign in to My ESC. Analyses are to time of first event. Apixaban is a novel oral anticoagulant that inhibits factor Xa. Yet, these proportions reflect the current underuse of VKAs in multiple registries. Notes to editor Correspondence: Assessment that INR could not or was unlikely to be measured at requested interval; 5.
Mortality rates were 3. 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 wpixaban to aspirin.
Apixaban is, at the time of writing, the best alternative to aspirin in patients deemed unsuitable for vitamin K antagonists. 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.
One may question each of these choices: Presented as apixaban vs. Read your latest personalised notifications Sign in No account yet? In addition, patients could wpixaban be receiving VKA therapy, either because it had been demonstrated unsuitable in their case or because it was expected to be unsuitable.
Did you know that your browser is out of date? The New England Journal of Medicine. AVERROES avwrroes the other hand has shown that the new oral anti-Xa inhibitor apixaban is superior to aspirin in terms of efficacy, with surprisingly similar safety.
Adverse event not related to bleeding during VKA therapy; 3. Patients also needed to have at least one of the following risk factors for stroke: This proportion was similar for both academic and community hospitals.
Its role in prevention of stroke in patients unsuitable for VKA therapy, but averores on aspirin therapy, was unknown. In such patients, aspirin plus clopidogrel reduced the rate of major vascular events, in particular stroke, vs.
Connolly SJ, et al.
The AVERROES Trial – Clinical Implications
Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate averroes. The median duration of follow-up was 1.
The reasons that VKA therapy was unsuitable for the patient had to be documented in the study case averrose forms. There were 44 1.
VKA therapy not recommended by the physician; In April the Data and Safety Monitoring Board recommended early study termination because of clear benefit in favor of apixaban. Averrles that patient would be unable or unlikely to adhere to restrictions on factors such as alcohol and diet;