Ashkan Shoamanesh

An analysis of the ARTESiA study found that the blood thinner apixaban helps prevent stroke in people with device-detected subclinical atrial fibrillation and a history of stroke or transient ischemic attack (TIA), a temporary blockage of blood flow to part of the brain.

Led by PHRI Senior Scientist Ashkan Shoamanesh and published in The Lancet Neurology, the substudy revealed that patients with a history of stroke or TIA experienced a significantly greater benefit from apixaban, with a 7% reduction in stroke risk over 3.5 years compared to aspirin. However, for patients with no history of stroke or TIA, the risk reduction was only 1%.

Jeff Healey

The findings are consistent with the ARTESiA study published in The New England Journal of Medicine, which also found that apixaban increased the risk of major bleeding. Patients with a history of stroke or TIA experienced a 3% increase in the risk of major bleeding when taking apixaban, compared to a 1% increase for those without a history of stroke.

“While the benefits of apixaban are clear for patients with subclinical atrial fibrillation, this substudy highlights the importance of considering a patient’s stroke or TIA history when determining treatment,” stated Jeff Healey, PHRI Senior Scientist and co-Principal Investigator of ARTESiA.

“Physicians should carefully weigh the increased benefits of apixaban against the higher risk of bleeding in patients with a history of stroke or TIA” said Shoamanesh. “We hope our study helps guide better decisions to improve health outcomes for these patients.”

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