Arrhythmias & electrophysiology
Asundexian or Apixaban in Patients With Atrial Fibrillation According to Prior Oral Anticoagulant Use: A Subgroup Analysis of the OCEANIC-AF Randomized Clinical Trial
Authors' conclusion
In the OCEANIC-AF randomized clinical trial, patients with AF who were OAC naive had a smaller increase in stroke or systemic embolism and a similar lower rate of bleeding with asundexian compared with apixaban than patients who were OAC experienced.
Study context
- Population
- Patients with atrial fibrillation (AF) in the OCEANIC-AF trial, categorised as OAC naive (≤6 weeks prior OAC use) or OAC experienced (>6 weeks)2,493 OAC naive
- Comparison
- Asundexian vs apixaban, by prior OAC use
- Primary endpoint
- Stroke or systemic embolism
Methodological detailsprespecified exploratory subgroup analysis, 1035 sites in 38 countries, Data analysed June to July 2024
- Prespecified exploratory subgroup analysis
- 1035 sites in 38 countries
- Data analysed June to July 2024
Primary result
As reported in the abstract
Stroke or systemic embolism, by prior OAC use
Asundexian vs ApixabanHazard ratio (95% CI)
OAC naive
1.42(0.54–3.73)
OAC experienced
4.66(2.84–7.65)
Safety
Major bleeding, by prior OAC use
Original publication
Asundexian or Apixaban in Patients With Atrial Fibrillation According to Prior Oral Anticoagulant Use: A Subgroup Analysis of the OCEANIC-AF Randomized Clinical Trial. JAMA Cardiol. Published 1 June 2025. doi:10.
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