Arrhythmias & electrophysiology
A Comparison of Outcomes With Apixaban, Rivaroxaban, and Warfarin for Atrial Fibrillation and/or Venous Thromboembolism
Authors' conclusion
For patients with AF and/or VTE, we observed that bleeding was highest with rivaroxaban, followed by warfarin, and then apixaban. Rates of thrombosis were higher with apixaban than with warfarin, largely driven by "other" thrombotic events.
Study context
- Population
- Adults with atrial fibrillation (AF) and/or venous thromboembolism (VTE) with at least 3 months of follow-uppatients meeting inclusion criteria (average age 66.7 years, 58.0% on anticoagulation for AF, average follow-up 28.2 months)
- Participants
- 13,435 adults
- Exposure
- Apixaban, rivaroxaban, and warfarin
- Outcome
- Apixaban vs warfarin: bleeding, thrombosis, mortality, healthcare utilization
Methodological details6 centers in Michigan, 2009 to 2023, matched
- 6 centers in Michigan
- 2009 to 2023
- Matched
Main finding
As reported in the abstract
Apixaban
3,527
matched n
Warfarin
3,527
matched n
Observational data: associations, not effects.
Further findings
Matched n
| Outcome | Apixaban | Rivaroxaban | Warfarin | |
|---|---|---|---|---|
| Rivaroxaban vs warfarin: bleeding, thrombosisAfter matching | Not reported in the abstract | 1,395 | 4,185 | apixaban: not reported in the abstract |
| Apixaban vs rivaroxaban: bleeding, mortality, thrombosisAfter matching | 1,395 | 1,395 | Not reported in the abstract | warfarin: not reported in the abstract |
Rivaroxaban vs warfarin: bleeding, thrombosis
- Any bleeding and major bleeding higher with rivaroxaban
- Thrombotic event rates similar, aside from a higher rate of "other" thrombosis with rivaroxaban
Apixaban vs rivaroxaban: bleeding, mortality, thrombosis
- Any bleeding, major bleeding, and mortality higher with rivaroxaban
- Thrombotic event rates similar
Original publication
A Comparison of Outcomes With Apixaban, Rivaroxaban, and Warfarin for Atrial Fibrillation and/or Venous Thromboembolism. JACC Adv. Published 25 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it