Topics


NOACs for Stroke Prevention in Atrial Fibrillation

Paper
(ARISTOTLE) Apixaban versus Warfarin in Patients with Atrial Fibrillation
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A RCT comparing apixaban to warfarin for stroke prevention in A fib, finding apixaban superior to warfarin for stroke/systemic embolism prevention with significantly reduced bleeding and mortality compared to warfarin
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(AVERROES) Apixaban in Patients with Atrial Fibrillation
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A RCT comparing apixaban to aspirin for stroke prevention in A fib patients who are unable to receive vitamin K antagonists, finding a clear benefit in stroke reduction with apixaban without a significantly increased risk of hemorrhage.
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(RE-LY) Dabigatran versus Warfarin in Patients with Atrial Fibrillation
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A RCT comparing dabigatran to warfarin for stroke prevention in A fib, finding that dabigatran at 110 mg BID was noninferior to warfarin for stroke prevention with significantly lower major bleeding, and at 150 mg BID is superior to warfarin for stroke prevention with similar risk of major bleeding.
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(ROCKET AF) Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation
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A RCT comparing rivaroxaban to warfarin for stroke prevention in A fib, finding rivaroxaban to be non-inferior to warfarin for stroke prevention with significantly less fatal and intracranial bleeding, and no significant difference in major bleeding.
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Effectiveness and Safety of Dabigatran, Rivaroxaban, and Apixaban Versus Warfarin in Nonvalvular Atrial Fibrillation
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A retrospective analysis of patients taking NOACs and warfarin for A fib with 3 matched cohorts comprised of apixaban vs warfarin, dabigatran versus warfarin, and rivaroxaban versus warfarin, finding that compared to warfarin, apixaban has lower risk of stroke and major bleeding, dabigatran has similar risk of stroke and lower risk of major bleeding, and rivaroxaban has similar risk of stroke and major bleeding.
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Meta-Analysis Comparing Apixaban Versus Rivaroxaban for Management of Patients With Nonvalvular Atrial Fibrillation
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A review and meta-analysis of observational studies including patients on apixaban and rivaroxaban for A fib comparing for stroke prevention and bleeding risk, finding a significantly lower risk of stroke/embolism, major bleeding, and GI bleeding with apixaban. The benefit of apixaban over rivaroxaban in these categories was greater with increasing CHA2DS2-VASC and HAS-BLED scores.
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