In an American comparative effectiveness study, the absolute reduction of ischemic stroke or major bleeding with apixaban versus dabigatran, rivaroxaban, or warfarin was greater in AF patients with than in those without dementia.
In the final ANNEXA-4 cohort of 479 patients with factor Xa (FXa) inhibitor–related major bleeding, andexanet alfa reduced anti-FXa activity and was associated with good or excellent hemostatic efficacy in 80% of them.
In a network meta-analysis of 7 RCTs, single antiplatelet therapy (SAPT) reduced the bleeding risk following TAVI by 55% compared with dual APT and also direct oral anticoagulants in patients with no indication for chronic oral anticoagulation, with no increase in all-cause death.
In patients with isolated distal deep vein thrombosis, extending rivaroxaban treatment by another 6 weeks resulted in a 41% lower risk of recurrent venous thromboembolism (VTE) compared with placebo.
European AF guidelines recommend treating patients with stable AF and an increased risk of stroke beyond 1 year after PCI with anticoagulant monotherapy, rather than dual therapy with an oral anticoagulant and antiplatelet drug. However, the evidence for this is scarce.
In an ATLANTIS substudy, apixaban reduced the risk of valve thrombosis after successful TAVR compared with antiplatelet therapy but not compared with VKAs. This coincided with a nonsignificant higher rate of thromboembolic and bleeding events.
ESC 2022 In a subpopulation of patients with rheumatic heart disease and AF, the effect of rivaroxaban vs. VKA was examined for the composite outcome of stroke, systemic embolism, MI and death from vascular or unknown cause.
ESC 2022 In the phase 2 AXIOMATIC-SSP trial, five doses of the FXIa inhibitor milvexian were examined for secondary prevention in patients with previous ischemic stroke or TIA.
ESC 2022 Ashkan Shoamanesh gives a summary of the primary results and exploratory analyses of the phase 2 PACIFIC-STROKE trial with asundexian in patients with non-cardioembolic stroke.
ESC 2022 There was no reduction of ischemic stroke or covert infarct with the FXIa inhibitor asundexian in patients with non-cardioembolic ischemic stroke. Exploratory analyses may give some insights about where and in whom benefit of this drug may be observed though.
ESC 2022 Following an acute MI, asundexian (oral factor XIa inhibitor) in addition to DAPT was shown to be safe but did not reduce ischemic events compared with placebo in a phase 2 trial.
ESC 2022 VKAs reduced ischemic stroke and mortality in patients with rheumatic AF compared with rivaroxaban without increasing major bleeding risk, according to the first RCT on anticoagulation in this population.