Number of Heart Failure Patients in Studies on Extended Anticoagulation with Apixaban
In studies on extended anticoagulation with apixaban, only a small percentage of patients with heart failure were included, with the AMPLIFY trial including 143 patients with cancer (2.7%) and the AMPLIFY-EXTEND trial including only 1.7% of patients with active cancer, with no specific data on heart failure patients.
Key Findings on Heart Failure Patients in Apixaban Studies
The AMPLIFY trial, which studied apixaban for initial treatment of VTE, included only 143 patients with cancer (2.7% of the total study population) 1.
The AMPLIFY-EXTEND trial, which evaluated extended anticoagulation with apixaban after completion of initial anticoagulation for VTE, included only a small percentage (1.7%) of patients with active cancer 1.
The guidelines specifically note that there is a lack of sufficient clinical data on apixaban in patients with cancer, which may include those with heart failure 1.
In the ARISTOTLE trial, which studied apixaban versus warfarin in patients with atrial fibrillation, patients with heart failure were included, but specific numbers were not provided in the available evidence 1.
Recent Research on Apixaban in Heart Failure
A more recent observational study (HEROES) included 459 heart failure patients with atrial fibrillation who were treated with DOACs, with 46.8% (approximately 215 patients) receiving apixaban 2.
Another study (AUGUSTUS) included patients with atrial fibrillation and acute coronary syndrome or undergoing percutaneous coronary intervention, but did not specifically report the number of heart failure patients 3.
A small case series reported on 7 patients with left ventricular thrombi and heart failure treated with apixaban 4.
Limitations of Current Evidence
The available evidence from major clinical trials shows very limited inclusion of heart failure patients in studies specifically examining extended anticoagulation with apixaban 1.
Most studies focused on VTE treatment or prevention in general populations, with heart failure patients representing only a small subset 1.
The National Comprehensive Cancer Network guidelines specifically note the lack of sufficient clinical data on apixaban in patients with cancer, which may overlap with heart failure populations 1.