Comparing Apixaban and Aspirin in Managing Ischemic Stroke Risk in Atrial Fibrillation Patients
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on March 1st, 2024
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Because of the irregular blood flow in individuals with atrial fibrillation, there is an elevated risk of ischemic stroke. Consequently, patients with AFib often receive Vitamin K antagonists and anticoagulants to mitigate the risk of blood clot formation. Earlier research indicated that Apixaban is more effective than aspirin in reducing the incidence of pulmonary embolism and stroke without elevating the risk of hemorrhage. Therefore, the Canadian Institutes of Health Research initiated a study to assess the potential of apixaban in managing the risk of ischemic stroke among patients with atrial fibrillation.
The study included 4012 patients whose cardiac electroconductivity was monitored using either a pacemaker, a defibrillator, or a cardiac monitor. These patients had encountered at least one episode of asymptomatic atrial fibrillation lasting over 6 minutes. The average age of the participants was 76.8 years, with 81.5% having a history of hypertension, 28.3% with a history of heart failure, and 9.0% having previously experienced stroke, systemic embolism, or transient ischemic attack. Patients were randomly assigned to receive oral treatment with either 5 mg of Apixaban twice daily or 81 mg of Aspirin daily. Following a median follow-up period of 3.5 years, the researchers found that Apixaban reduced the risk of stroke or systemic embolism by 37%. Despite the clinical benefits, caution should be exercised in the use of Apixaban due to a 36% increase in the risk of bleeding.
The study included 4012 patients whose cardiac electroconductivity was monitored using either a pacemaker, a defibrillator, or a cardiac monitor. These patients had encountered at least one episode of asymptomatic atrial fibrillation lasting over 6 minutes. The average age of the participants was 76.8 years, with 81.5% having a history of hypertension, 28.3% with a history of heart failure, and 9.0% having previously experienced stroke, systemic embolism, or transient ischemic attack. Patients were randomly assigned to receive oral treatment with either 5 mg of Apixaban twice daily or 81 mg of Aspirin daily. Following a median follow-up period of 3.5 years, the researchers found that Apixaban reduced the risk of stroke or systemic embolism by 37%. Despite the clinical benefits, caution should be exercised in the use of Apixaban due to a 36% increase in the risk of bleeding.