Deans' stroke musings: Apixaban Associated With Lower Risk of Stroke Than Rivaroxaban in Patients With AF, Valvular Heart Disease

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, October 21, 2022

Apixaban Associated With Lower Risk of Stroke Than Rivaroxaban in Patients With AF, Valvular Heart Disease

For discussion with your doctor.

Apixaban Associated With Lower Risk of Stroke Than Rivaroxaban in Patients With AF, Valvular Heart Disease

Among patients with atrial fibrillation (AF) and valvular heart disease (VHD), patients receiving apixaban had a lower risk for ischaemic stroke or systemic embolism and for bleeding when compared with those receiving rivaroxaban, according to a study published in Annals of Internal Medicine.

“The lack of clinical trial evidence and wide use of both drugs in patients with AF and VHD calls for real-world evidence that can guide treatment selection in clinical practice,” said Ghadeer Dawwas, PhD, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

For the real-world study, the researchers analysed data from a commercial health insurance database (January 2013-December 2020) and identified 9,947 patients who had recently started taking apixaban and compared them with another 9,947 patients newly taking rivaroxaban. All patients were matched for age and other characteristics that could affect outcomes.

When compared with rivaroxaban, apixaban was associated with a lower rate of ischeamic stroke or systemic embolism (hazard ratio [HR] = 0.57; 95% confidence interval [CI], 0.40-0.80) and bleeding (HR = 0.51; 95% CI, 0.41-0.62).

The absolute reduction in the probability of stroke or systemic embolism with apixaban compared with rivaroxaban was 0.0026 within 6 months and 0.011 within 1 year of treatment initiation. The absolute reduction in the probability of bleeding events with apixaban compared with rivaroxaban was 0.012 within 6 months and 0.019 within 1 year of treatment initiation

The researchers calculated that the rate of stroke or systemic embolism per patient per year of follow-up was 0.91% for rivaroxaban users compared with 0.52% for apixaban users.

“Until evidence from randomized controlled trials becomes available, we believe clinicians should consider our findings when selecting anticoagulants in patients with AF and VHD,” said senior author Sean Hennessy, PhD, University of Pennsylvania.

Reference: https://www.acpjournals.org/doi/10.7326/M22-0318

SOURCE: University of Pennsylvania School of Medicine