Apixaban reduces the risk of stroke in patients with AFib
The results of the EMANATE trial, presented at the European Society of Cardiology (ESC) Congress in Barcelona, showed that when compared to warfarin with heparin in patients that had received less than 48 hours of anticoagulation therapy, the risk of stroke was reduced with apixaban (Equilis, Bristol-Myers Squibb).Apixaban is the generic drug of Eliquis. It is an anticoagulant used in patients with atrial fibrillation to control and prevent blood clots and to prevent stroke. Apixaban, a factor Xa-inhibiting blood thinner, was shown to decrease the risk of stroke compared to warfarin in patients with elective cardioversion atrial fibrillation who were naive to anticoagulation.
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Heparin and warfarin, which involve supervision and future dosage modification, are the existing standard of care to reduce the risk of stroke in a cardioversion environment. This may prolong cardioversion. As a potential alternative solution, the EMANATE study points to apixaban. In order to confirm these findings, further research is merited.
Apixaban was given twice daily in an oral 5 mg dose of prescription medication (or 2.5 mg twice daily to patients 80 years of age or older, weighing less than 60 kg or possessing plasma creatinine levels higher than 1.5 mg / dL) for 753 patients, whereas 747 patients obtained regular heparin warfarin medication. Of the 753 patients on apixaban, an initial 10 or 5 mg dosage for apixaban was given to a subgroup of 342 patients if cardioversion was immediate. All were associated with levels of acute embolism, death severe bleeding, and clinically relevant non-major bleeding.
None of the patients receiving apixaban suffered stroke relative to 6 in the regular care research arm (p= 0.01), while significant bleeding occurred in 3 patients in the apixaban group compared to 6 in the usual care category, and non-major bleeding occurred in 11 patients and 13 respectively. In the apixaban community, there were 2 fatalities relative to 1 in the normal treatment category.
Heparin and warfarin, which involve supervision and future dosage modification, are the existing standard of care to reduce the risk of stroke in a cardioversion environment. This may prolong cardioversion. As a potential alternative solution, the EMANATE study points to apixaban. In order to confirm these findings, further research is merited.
Apixaban was given twice daily in an oral 5 mg dose of prescription medication (or 2.5 mg twice daily to patients 80 years of age or older, weighing less than 60 kg or possessing plasma creatinine levels higher than 1.5 mg / dL) for 753 patients, whereas 747 patients obtained regular heparin warfarin medication. Of the 753 patients on apixaban, an initial 10 or 5 mg dosage for apixaban was given to a subgroup of 342 patients if cardioversion was immediate. All were associated with levels of acute embolism, death severe bleeding, and clinically relevant non-major bleeding.
None of the patients receiving apixaban suffered stroke relative to 6 in the regular care research arm (p= 0.01), while significant bleeding occurred in 3 patients in the apixaban group compared to 6 in the usual care category, and non-major bleeding occurred in 11 patients and 13 respectively. In the apixaban community, there were 2 fatalities relative to 1 in the normal treatment category.
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Clinicians also recommend quicker cardioversion after a person is diagnosed with non-valvular atrial fibrillation due to the more likely the individual is to adapt to normal heart rhythm. Apixaban with or without a loading dosage was effective for patients with atrial fibrillation experiencing cardioversion, contributing to a few bleeding incidents and fewer strokes than traditional anticoagulant therapy.
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