Ahmed Koriesh on Comparison of Apixaban and Warfarin
Ahmed Koriesh, Director Hospital Neurology Service at Cleveland Clinic Florida, shared on LinkedIn:
”How many patients have you seen with stroke or bleeding related to warfarin in LVAD patients?
A recent trial in LVAD patients compared apixaban with warfarin over 2 years:
Lower HRAEs (stroke, bleeding, thrombosis):
12.5% vs 43% (p=0.087)
Significantly fewer transfusions:
0.69 vs 4.82 EPPY (p<0.01)
Win ratio favored apixaban:
2.30 (95% CI 0.95–5.60)
Although underpowered, the signals consistently leaned toward apixaban with no excess thrombosis or mortality observed.
Bottom line:
Apixaban is showing a promise as a safe alternative to warfarin in selected LVAD patients — larger trials are needed before changing practice.”
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