Clinical and Economic Implications of Apixaban Versus Aspirin in the Low-Risk Nonvalvular Atrial Fibrillation Patients

Stroke; a Journal of Cerebral Circulation
Gregory Y H LipPaul Dorian

Abstract

Although recommended by guidelines, the benefits of treating patients with atrial fibrillation with a low-stroke risk score, with aspirin or anticoagulants, have not been clearly established. With advent of safer non-vitamin K antagonist oral anticoagulant, we assessed the clinical and economic implications of 5 mg BID of apixaban versus aspirin among patients with a relative low risk of stroke as assessed using the CHADS2 (congestive heart failure, hypertension, age>75, diabetes mellitus, stroke/transient ischemic attack) and CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke/transient ischemic attack, vascular disease) stroke risk classification. A previously developed and validated Markov model was adapted. A secondary analysis of the Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment (AVERROES) study was conducted to estimate event rates in different low-risk cohorts by treatment. Three cohorts (n=1000) with a CHADS2 score of 1, CHA2DS2-VASc score of 1, and CHA2DS2-VASc of score 2 to 4 were simulated to assess the number of clinical events avoided in terms of strokes and major bleeds, as...Continue Reading

References

Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Sep 9, 1996·Archives of Internal Medicine·B F GageD K Owens
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Oct 7, 2009·Journal of Managed Care Pharmacy : JMCP·Michael E StokesDon P Buesching
Jan 26, 2010·Thrombosis Research·Alok A Khorana
Jul 9, 2010·The American Journal of Medicine·Isla M OgilvieGregory Y H Lip
Jul 28, 2010·Hematology/oncology Clinics of North America·John Winters, David Garcia
Sep 30, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·A John CammUNKNOWN ESC Committee for Practice Guidelines
Feb 12, 2011·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN AVERROES Steering Committee and Investigators
Mar 23, 2011·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Patrick W SullivanVahram Ghushchyan
Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Aug 30, 2011·The New England Journal of Medicine·Christopher B GrangerUNKNOWN ARISTOTLE Committees and Investigators
May 10, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·Ramon Luengo-FernandezPeter M Rothwell
May 24, 2012·Stroke; a Journal of Cerebral Circulation·Emer R McGrathUNKNOWN Investigators of the Registry of the Canadian Stroke Network
Aug 29, 2013·Stroke; a Journal of Cerebral Circulation·Staffan BjörckLennart Bergfeldt
Nov 21, 2013·The New England Journal of Medicine·Robert P GiuglianoUNKNOWN ENGAGE AF-TIMI 48 Investigators
May 3, 2014·Stroke; a Journal of Cerebral Circulation·Walter N KernanUNKNOWN American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and
Jul 22, 2014·Pacing and Clinical Electrophysiology : PACE·Duo HuangChung-Wah Siu
Mar 17, 2015·Journal of the American College of Cardiology·Gregory Y H LipTorben Bjerregaard Larsen

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