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Therapeutics
Randomised controlled trial
In people with atrial fibrillation unsuitable for warfarin, apixaban reduces the risk of stroke compared with aspirin, with no difference in major bleeding
  1. Renato D Lopes1,
  2. David A Garcia2
  1. 1Cardiology, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
  2. 2Hematology/Oncology, University of New Mexico, Albuquerque, New Mexico, USA
  1. Correspondence to: Renato D Lopes
    Cardiology, Duke University Medical Center, Duke Clinical Research Institute, Box 3850, 2400 Pratt Street, Room 0311, Durham, NC 27705, USA; renato.lopes{at}duke.edu

https://doi.org/10.1136/ebm.2011.0023

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    Commentary on: Connolly SJ, Eikelboom J, Joyner C, et al. Apixaban in patients with atrial fibrillation. N Engl J Med 2011;364:806–17.OpenUrlCrossRefPubMedWeb of Science

    Context

    Atrial fibrillation (AF) is a common dysrhythmia associated with reduced quality of life, higher risk of developing heart failure, cognitive impairment and increased mortality.1,–,3 Patients with AF have a five-fold increased risk of stroke, and up to 25% of all strokes in the elderly are a consequence of AF.4 Vitamin K antagonists (VKAs) reduce the risk of stroke in patients with AF by 64% compared with placebo.5 Unfortunately, many patients at risk for AF-related stroke do not take VKA for a variety of reasons.6,–,8 Aspirin is an alternative antithrombotic strategy which is less effective than VKA but probably more effective than …

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    Footnotes

    • Competing interests RDL and DAG are members of the ARISTOTLE trial's Steering Committee.