Meta-analysis: Efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation for prophylaxis of adverse cardiovascular events

Authors

  • Mariela Alexandra Idrovo Vallejo Carrera de Enfermería de la Facultad de la Salud Humana, Universidad Nacional de Loja. Loja, Ecuador
  • Paula Blandin-Lituma Carrera de Biofarmacia de la Unidad Académica de Salud y Bienestar, Universidad Católica de Cuenca. Cuenca, Ecuador

DOI:

https://doi.org/10.54753/cedamaz.v12i2.1266

Keywords:

Apixaban, Warfarin, Atrial fibrillation, Prophylaxis, Cardiovascular event

Abstract

Abstract—Patients with atrial fibrillation (AF) require anticoagulant therapy to prevent adverse cardiovascular events. A widely used drug is warfarin with variable and inconsistent benefits and an increased risk of bleeding. Given this, new therapeutic alternatives are arising and need to be evaluated, such as apixaban, and that its the purpose of conducting this meta-analysis. PubMed and Cochrane Library databases were used. The study included 62,141 patients with AF from 6 ARISTOTLE-type randomized clinical trials. The fixed effect test was applied for the grouped results, and the homogeneity of the analyzed data was tested. The meta-analysis was performed to evaluate the proposed variables (efficacy and safety). The efficacy assessment established that apixaban appears to be more effective than warfarin in preventing stroke (OR = 0.81; LC 95% = 0.74-0.90; p-value <0.05) and in death from all causes (OR = 0.90; LC 95% = 0.84-0.95; p-value <0.05). In the prophylaxis of myocardial infarction (OR = 0.91; LC 95% = 0.7-1; p-value >0.05) no significant difference between both drugs was found. In the safety assessment, it was determined that the risk of major bleeding (OR = 0.7; LC 95% = 0.6-0.7; p-value <0.05) is lower with apixaban compared to warfarin. In conclusion, the use of apixaban shows better results than warfarin in preventing adverse cardiovascular events; however, more studies are required to verify these findings. Keywords: Apixaban, warfarin, atrial fibrillation, prophylaxis, and cardiovascular event.

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Published

2022-12-29

How to Cite

Idrovo Vallejo, M. A., & Blandin-Lituma, P. . (2022). Meta-analysis: Efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation for prophylaxis of adverse cardiovascular events. CEDAMAZ, 12(2). https://doi.org/10.54753/cedamaz.v12i2.1266

Issue

Vol. 12 No. 2 (2022): CEDAMAZ

Section

Ciencias de la salud y biotecnología

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