Apixaban in atrial fibrillation: does predicted risk matter?

摘要

Since its discovery in 1922 warfarin has been the major therapeutic agent for reduction of thromboembolic risk in patients with atrial fibrillation. Its benefits are well documented, and include a 64% relative risk reduction in stroke.2 However, drug and diet interactions can lead to an unpredictable dose response and can reduce its clinical effectiveness, sometimes with catastrophic results. Furthermore, the need for regular monitoring makes it unattractive for many patients. As a result, use of warfarin in patients with atrial fibrillation is not ideal, especially in those at highest risk for thromboembolic events.