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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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? Hospitalized patients with atrial fibrillation and a high risk of stroke are not being avverroes with adequate anticoagulation.
Patients also needed to have at least one of the following risk factors for averrows Apixaban is, at the avrrroes of writing, the best alternative to aspirin in patients deemed unsuitable for vitamin K antagonists. Guidelines for the management of atrial fibrillation: Of the patients enrolled, reasons for being deemed unsuitable for VKA therapy included the following: We will here briefly discuss the clinical implications of the trial.
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 to aspirin.
The AVERROES Trial – Clinical Implications
Mortality rates were 3. Dabigatran versus warfarin in patients with atrial fibrillation.
Usable articles Cardiology Neurology. The reasons that VKA therapy was unsuitable for the patient had to be documented in the study case report forms. J Am Coll Cardiol ; All these reasons can be grouped in three broad categories: Read your latest personalised notifications Sign in No account yet? Its role in prevention of stroke in patients unsuitable for VKA therapy, but maintained on aspirin therapy, was unknown. Assessment that INR could not or was unlikely to be measured at requested interval; 5.
VKA therapy not recommended by the physician; Expected difficulty in contacting patient for urgent change in dose of VKAs; 6. ESC sub specialties communities.
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. Analyses are to time of first event. Apicaban Heart J ; Dual therapy decreased rates of major vascular events at cost of increased major bleeding. Apixaban is a novel oral anticoagulant that inhibits factor Xa.
The AVERROES Trial – Clinical Implications
The New England Journal of Medicine. N Engl J Med ; N Engl J Med Statistics presented where given by the authors.
Views Read View source View history. The primary outcome was stroke or systemic embolism. Connolly SJ, et al.
AVERROES – Wiki Journal Club
Strengths Strong points and important messages of the study are: Aveeroes in to My ESC. To reduce the burden of cardiovascular disease. Retrieved from ” http: Thus, a clear superiority of apixaban over aspirin was shown in terms of efficacy, with comparable safety. The trial was terminated early given a treatment benefit with apixaban. Presented as apixaban vs. Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients aoixaban atrial fibrillation according to stroke risk: Notes to editor Correspondence: AVERROES on 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.
Other characteristics indicating risk of stroke too low to warrant treatment with VKAs; Averrose were 51 primary outcome events in those randomised to apixaban 1. It has multiple theoretical benefits over VKA therapy including less intensive monitoring and fewer drug interactions. Assessment that patient would be unable or unlikely to adhere to restrictions on factors such as alcohol and diet; Did you know that your browser is out of date? Navigation menu Personal tools Create account Log in.
One may question each of these choices: There were 11 intracranial bleeds on apixaban and 13 on aspirin apixaban 1. Apixagan April the Data and Safety Monitoring Board recommended early averrofs termination because of clear benefit in favor of apixaban.
Concurrent medications that could alter activity of VKAs; 8.