{"id":9114,"date":"2025-10-27T21:57:58","date_gmt":"2025-10-27T18:57:58","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9114"},"modified":"2025-10-27T21:57:58","modified_gmt":"2025-10-27T18:57:58","slug":"apixaban-in-atrial-fibrillation","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/apixaban-in-atrial-fibrillation\/","title":{"rendered":"Apixaban in Atrial Fibrillation\u00a0"},"content":{"rendered":"
Apixaban in Atrial Fibrillation<\/div>\n
<\/div>\n
Source: Jordan Cardiac Society Conference \u2013 October 16\u201317 2025<\/div>\n
<\/div>\n
Speaker: Dr. Raed Awaisheh,Interventioal Cardiologist<\/div>\n
<\/div>\n
Keynotes :<\/div>\n
1.\u2060 \u2060Atrial Fibrillation Overview<\/div>\n
\u2022 AF is the most common arrhythmia, increasing stroke risk five-fold.<\/span><\/div>\n
\u2022 Responsible for about one-third of strokes in patients \u2265 65 years.<\/span><\/div>\n
\u2022 AF-related strokes cause higher mortality (\u2248 50 % at 1 year) and greater long-term disability.<\/span><\/div>\n
\u2022 Types:<\/span><\/div>\n
\u2022 Valvular AF \u2192 prosthetic valve, stenosis, or regurgitation.<\/span><\/div>\n
\u2022 Non-valvular AF (NVAF) \u2192 often due to hypertension, thyroid disease, or structural heart change.<\/span><\/div>\n
<\/div>\n
2.\u2060 \u2060Risk Stratification<\/div>\n
\u2022 CHA\u2082DS\u2082-VASc \u2192 assesses thromboembolic risk and guides anticoagulation. CHA\u2082DS\u2082-VASc = 1 is the threshold where anticoagulation should be considered<\/span><\/div>\n
\u2022 HAS-BLED \u2192 identifies bleeding risk factors:<\/span><\/div>\n
H \u2013 Hypertension > 160 mmHg<\/div>\n
A \u2013 Abnormal renal \/ liver function (1 point each):<\/div>\n
\u2003\u2003\u2022 Significant Renal Impairment : renal transplant or Cr > 2.3 mg\/dL<\/div>\n
\u2003\u2003\u2022 Liver : bilirubin > AST\/ALT\/ALP > 3\u00d7 ULN<\/div>\n
S \u2013 Stroke history<\/div>\n
B \u2013 Bleeding history or predisposition<\/div>\n
L \u2013 Labile INR (< 60 % TTR)<\/div>\n
E \u2013 Elderly > 65 years<\/div>\n
D \u2013 Drugs (antiplatelets\/NSAIDs) or alcohol > 8 units\/week<\/div>\n
Interpretation Summary<\/div>\n
\u2022\u2060\u00a0 \u2060HAS-BLED 0\u20131 \u2192 Low risk \u2192 standard anticoagulation<\/div>\n
\u2022\u2060\u00a0 \u2060HAS-BLED 2 \u2192 Moderate risk \u2192 proceed with caution and correct modifiable factors<\/div>\n
\u2022\u2060\u00a0 \u2060HAS-BLED \u2265 3 \u2192 High risk \u2192 intensify \u201cmonitoring\u201d but do not withhold anticoagulation\u2014focus on risk mitigation<\/div>\n
<\/div>\n
3.\u2060 \u2060Apixaban \u2013 Simplified Dosing Summary<\/div>\n
\u2022 Standard dose: 5 mg twice daily for most NVAF patients.<\/span><\/div>\n
\u2022 Reduced dose (2.5 mg twice daily): only if \u2265 2 of the following apply \u2192 age \u2265 80 y, weight \u2264 60 kg, or serum creatinine \u2265 1.5 mg\/dL.<\/span><\/div>\n
\u2022 Key point: creatinine elevation alone does not mandate dose reduction.<\/span><\/div>\n
\u2022 Renal impairment: dosing decisions depend on age, weight, and creatinine, not kidney function alone; even in end-stage renal disease, the standard 5 mg BID remains appropriate unless \u2265 2 reduction criteria are met.<\/span><\/div>\n
\u2022 Clinical note: Apixaban is the only DOAC approved for patients with AF on dialysis \u2014 shown to reduce both bleeding and thrombotic events compared to warfarin.<\/span><\/div>\n
<\/div>\n
5.\u2060 \u2060Evidence-Based Highlights<\/div>\n
\u2022 Apixaban reduces stroke \/ systemic embolism, major bleeding, and mortality vs warfarin.<\/span><\/div>\n
\u2022 Meta-analyses confirm superior effectiveness and safety vs other DOACs.<\/span><\/div>\n
\u2022 Proven benefit in elderly and CKD patients with consistent outcomes across studies.<\/span><\/div>\n
<\/div>\n
6.\u2060 \u2060Key Takeaways<\/div>\n
\u2022 Superior efficacy and safety across all patient groups.<\/span><\/div>\n
\u2022 Only DOAC approved for ESKD on dialysis.<\/span><\/div>\n
\u2022 Predictable dose, no INR testing, and minimal interactions \u2192 simplifies management.<\/span><\/div>\n
\u2022 Close monitoring and correction of modifiable HAS-BLED factors remain essential for safe therapy.<\/span><\/div>\n","protected":false},"excerpt":{"rendered":"

Apixaban in Atrial Fibrillation Source: Jordan Cardiac Society Conference \u2013 October 16\u201317 2025 Speaker: Dr. Raed Awaisheh,Interventioal Cardiologist Keynotes : 1.\u2060 \u2060Atrial Fibrillation Overview \u2022 AF is the most common arrhythmia, increasing stroke risk five-fold. \u2022 Responsible for about one-third of strokes in patients \u2265 65 years. \u2022 AF-related strokes cause higher mortality (\u2248 50 […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9114","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9114"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9114\/revisions"}],"predecessor-version":[{"id":9115,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9114\/revisions\/9115"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}