AHA 2023 — Dr Naima Maqsood, CardioNerds ambassador (Temple University Hospital, US) interviews investigator, Dr Jeff Healey (McMaster University, CA) to outline the findings from a phase 4 trial of apixaban to reduce thromboembolism in patients with subclinical atrial fibrillation (AF).

ARTESiA (NCT01938248) aims to determine if apixaban in combination with aspirin can reduce the instance of ischemic stroke and embolism in patients with device-detected subclinical AF.  Patients will be randomized to receive either apixaban or aspirin. Apixaban dose will be 5 mg twice daily. Those assigned to aspirin will receive a dose of 81 mg daily. This is an event-driven study, and will continue until 248 patients out of 4012 participants have experienced a clinical event. 

Apixaban reduced the risk of stroke or systemic embolism in patients with subclinical atrial fibrillation, with fatal and disabling strokes reduced by 49%. An increase in major bleeding was observed with apixaban, however, there was no increase found in fatal or intracranial bleeding detected. This suggests that anticoagulation should be considered for patients with subclinical atrial fibrillation who have additional stroke risk factor.

Recorded on-site at AHA 23, Philadelphia. 

Supported by an educational grant from Novo Nordisk Inc. This content is not intended for UK HCPs.