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Medical Articles Source: PubMed
Topic: Apixaban vs. Aspirin for Stroke Prevention in Subclinical AfibBackground: This ARTESiA subgroup analysis assessed apixaban vs. aspirin in patients with prior stroke/TIA.
Methods: A double-blind RCT at 247 sites in 16 countries
included
4,012 adults (≥55 years, CHA2DS2-VASc ≥3) with
device-detected subclinical Afib. 346 patients with prior stroke/TIA received apixaban 5 mg bid or aspirin 81 mg daily.
Findings:▪️Stroke/systemic embolism rates: 1.20% (apixaban) vs. 3.14% (aspirin) (HR 0.40)
▪️Major bleeding: 2.26%
(apixaban) vs. 1.16% (aspirin) (HR 1.94)
▪️Absolute risk reduction: 7% (prior stroke/TIA) vs. 1% (no prior stroke/TIA)
Conclusion: Apixaban significantly reduces stroke risk (7% absolute reduction) but increases major bleeding (3% absolute increase) in subclinical Afib with prior stroke/TIA. Careful risk-benefit assessment is needed.
Link:
https://pubmed.ncbi.nlm.nih.gov/39862882/@HakimApps_Guideline