Arrhythmias & electrophysiology
Effectiveness and safety of rivaroxaban vs. apixaban in patients with atrial fibrillation and peripheral artery disease
Authors' conclusion
In patients with NVAF and PAD, rivaroxaban was associated with a similar risk of MALE and stroke/TIA/SE, but a higher risk of MB compared with apixaban.
Study context
- Population
- Patients aged ≥45 years with incident non-valvular atrial fibrillation (NVAF) and peripheral artery disease (PAD) initiating rivaroxaban or apixaban, UK CPRD, 2013–2021
- Participants
- 6,170 vs 9,990
- Exposure
- Rivaroxaban vs apixaban
- Rivaroxabann = 6,170
- Apixabann = 9,990reference
- Outcome
- MALE; composite of ischaemic stroke, TIA or systemic embolism (primary effectiveness); major bleeding (primary safety)
Methodological detailspropensity score fine stratification and weighting
- Propensity score fine stratification and weighting
Main finding
As reported in the abstract
MALE; ischaemic stroke/TIA/SE
- Incidence rates similar for major adverse limb events (MALE) and stroke/transient ischaemic attack (TIA)/SE
- Propensity score fine stratification and weighting
Observational data: associations, not effects.
Secondary outcomes
Major cardiovascular events (MACE)
- Incidence rates similar for MACE
Safety
| Outcome | Rivaroxaban | Apixaban | aHR (95% CI) | |
|---|---|---|---|---|
| Major bleeding (primary safety outcome) | 46.1 /1000 person-years | 29.8 /1000 person-years | 1.55 (1.36–1.77) | |
| 0.512Adjusted hazard ratio (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Effectiveness and safety of rivaroxaban vs. apixaban in patients with atrial fibrillation and peripheral artery disease. Eur Heart J Cardiovasc Pharmacother. Published 30 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it