Secondary analysis of the ARISTOTLE trial has found that the prophylactic benefits of apixaban over warfarin hold for paroxysmal, permanent and persistent atrial fibrillation (AF).
The results presented by Dr Sana Al-Khatib at the Heart Rhythm Society 2012 Scientific Sessions add to earlier findings from the ARISTOTLE trial, that apixaban is more effective at stroke and systemic embolism prevention in AF patients than warfarin.
ARISTOTLE enrolled AF patients who had one or more risk factor for stroke or embolism.
The results contradict the widely accepted belief that outcomes for AF patients with stroke and systemic embolism are comparable whether the AF is paroxysmal, persistent or permanent, Dr Sana Al-Khatib (Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA) told the website heartwire.
The new data indicates that stroke and systemic embolism risks are higher in patients with permanent or persistent AF than those with paroxysmal AF.
The established findings of ARISTOTLE, which involved 18,201 patients, indicated that apixaban reduced risk of stroke or systemic embolism by a significant 21%, compared with warfarin. Risk of bleeding and of death from any cause over the 1.8 year average follow-up were reduced by 31% and 11%, respectively, with apixaban over warfarin.