atrial fibrillation and stroke prevention - Continuing Medical ...
atrial fibrillation and stroke prevention - Continuing Medical ...
atrial fibrillation and stroke prevention - Continuing Medical ...
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Essentials in Primary Care Conference<br />
Wednesday, July 31, 2013<br />
Contrasting the 3 New Oral Agents<br />
• Apixaban prevents about 3 more <strong>stroke</strong>s per 1000 patients<br />
per year than warfarin. Plus it leads to 10 FEWER bleeds<br />
<strong>and</strong> 4 FEWER deaths.<br />
• Rivaroxaban doesn’t prevent more <strong>stroke</strong>s than<br />
warfarin...<strong>and</strong> has a similar risk of bleeding. But it’s the<br />
only new agent given just ONCE daily.<br />
• Dabigatran prevents about 5 more <strong>stroke</strong>s per 1000<br />
patients per year than warfarin...with a similar overall<br />
bleeding risk. Dabigatran is also the only new agent that<br />
reduces ISCHEMIC <strong>stroke</strong>s compared to warfarin...in<br />
addition to HEMORRHAGIC <strong>stroke</strong>s.<br />
Pharmacists/Physicians Letter Feb 2013.<br />
Optimal C<strong>and</strong>idates for Warfarin<br />
Patients who:<br />
• Have (borderline) renal insufficiency<br />
• Are taking stable dose of warfarin <strong>and</strong> do not<br />
find INR testing burdensome<br />
• Have access to self-testing machine or other<br />
reliable means of regular INR monitoring<br />
• Are concerned about the lack of an evidencebased<br />
reversal strategy<br />
• Has issues with out-of-pocket expense<br />
Jan Basile, MD<br />
Atrial Fibrillation & Stroke Prevention
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