Date of Award

2024

Document Type

Capstone

Degree Name

Master of Science (MS)

Committee Chair

Trey Boyd

Abstract

Introduction: Atrial fibrillation is a cardiac arrythmia that increases risk of stroke. The prevention strategy for this is anticoagulation, historically with the medication warfarin, but more recently with the factor Xa inhibitor apixaban. The purpose of this paper is to compare the efficacy of apixaban and warfarin for stroke prevention.

Methods: PubMed was searched using the key terms “atrial fibrillation,” “stroke prevention,” “warfarin,” and “apixaban.” Only relevant articles comparing apixaban to warfarin were included among RCTs, systematic reviews, and meta-analyses from the last 5 years. Four were chosen for review based on content and data quality.

Results: Three articles were systematic reviews or meta-analyses. One compared anticoagulants based on time to event. In total, data points for 1,065,827 patients were evaluated among the four studies. Results were reported as relative risk, hazard ratios, and gain in event free time. Relative risk and hazard ratios for stroke were both lower for apixaban in all but one study analyzed. Gain in event free time was increased in patients treated with apixaban.

Discussion: Patients treated with apixaban were found to have reduced risk of stroke when compared to patients treated with warfarin. Apixaban also showed increase in event free time even when patients did experience a stroke.

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