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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Of the patients enrolled, reasons for being deemed unsuitable for VKA therapy included the following: Sign in to My ESC.

A serious bleeding event during VKA therapy; 4. Concurrent medications whose metabolism could be affected by VKAs; 9. Did you know that your browser is out of date? Views Read View source View history.

All these reasons can be grouped in three broad categories: Analyses are to time of first event. Apixaban in Patients with Atrial Fibrillation.

Apixaban is, at the time of writing, the best alternative to aspirin in patients deemed unsuitable for vitamin K antagonists. With a mean follow-up of 1. The primary outcome was stroke or systemic embolism.

ESC sub specialties communities. Thus, a clear superiority of apixaban over aspirin was shown in terms of efficacy, with comparable safety. Read your latest personalised notifications Sign in No account yet? The New England Journal of Medicine.


AVERROES – Wiki Journal Club

Strengths Strong points and important messages of the study are: Retrieved from ” http: This proportion was similar for both academic and community hospitals. Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation. Presented as apixaban vs. 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 such patients, aspirin plus clopidogrel reduced the rate of major vascular events, in particular stroke, vs. One may question each of these apisaban The median duration of follow-up was 1. Adverse event not related to bleeding during VKA therapy; 3. In April the Data and Safety Monitoring Board recommended early study termination because of clear benefit in favor of apixaban.

Connolly SJ, et al. N Engl J Med ; Apixaban is a novel oral anticoagulant that inhibits factor Xa. Yet, these proportions reflect apixabann current underuse of VKAs in multiple registries.

This page was last modified on 3 Decemberat Don’t miss out Read your latest personalised notifications Apixabaj, got it. Its role in prevention of stroke in patients unsuitable for VKA therapy, but maintained on aspirin therapy, was unknown. There were 44 1.

The trial was terminated early given a treatment benefit with apixaban. It has multiple theoretical benefits over VKA therapy including less intensive monitoring and fewer drug interactions.


Expected difficulty in contacting patient for urgent change in dose of VKAs; 6. There were 51 primary outcome events in those randomised to apixaban 1. Patients also needed to have at least one of the following risk factors for stroke: Also, how does apixaban compare to aspirin rates of major bleeding? There were 11 intracranial bleeds on apixaban and 13 on aspirin apixaban 1.

Assessment that patient would be unable or unlikely to adhere to restrictions on factors such as alcohol and diet; Effect of clopidogrel added to aspirin in patients with atrial fibrillation. To reduce the burden of cardiovascular disease. Dual therapy decreased rates of major vascular events at cost of increased major bleeding. 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.

Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk: Usable articles Cardiology Neurology.

J Am Coll Avreroes ; Eur Heart Apixabam ; Concurrent medications that could alter activity of VKAs; 8.