From the Guidelines
Aspirin (acetylsalicylic acid) and Eliquis (apixaban) are both used to prevent thrombotic events, with aspirin being an antiplatelet agent and apixaban being an anticoagulant.
Key Similarities
- Both are used to reduce the risk of stroke and systemic embolism in patients with atrial fibrillation (AF) or acute coronary syndromes (ACS) 1
- They can be used together in certain clinical scenarios, such as after valve implantation or in patients with AF and ACS, although this combination increases the risk of bleeding 1
Mechanism of Action
- Aspirin works by inhibiting cyclo-oxygenase-1 (COX-1) and blocking the formation of thromboxane A2, which induces a functional permanent inhibition in platelets 1
- Apixaban, on the other hand, is a direct factor Xa inhibitor that prevents thrombin formation and reduces the risk of thrombotic events 1
Clinical Use
- Aspirin is recommended for all patients with suspected acute coronary syndromes in the absence of contraindications, with a dose range of 75-325 mg per day 1
- Apixaban is approved for the reduction of risk of stroke and systemic embolism in patients with nonvalvular AF, with a recommended dose of 5 mg twice daily 1
Important Considerations
- The combination of aspirin and apixaban should be used with caution, as it increases the risk of bleeding, and the dose of aspirin should not exceed 100 mg in these cases 1
- Clinicians should carefully assess the risk and benefit of concomitant anticoagulant and antiplatelet therapy and adhere to current recommendations to minimize the risk of adverse bleeding 1
From the Research
Commonalities between Aspirin and Eliquis (Apixaban)
- Both aspirin and apixaban are used for stroke prevention in patients with atrial fibrillation 2, 3, 4, 5, 6
- They have been compared in clinical trials, such as the AVERROES trial, which showed that apixaban was associated with a lower risk of stroke or systemic embolism than aspirin in patients with atrial fibrillation who were unsuitable for vitamin K antagonist therapy 2, 3
- Both medications have been shown to have similar risks of major bleeding in certain patient populations 3, 5
- The choice between aspirin and apixaban may depend on the patient's individual risk factors, such as their CHA2DS2-VASc score 5
- Both medications are used to prevent thromboembolic events, although they work through different mechanisms of action 2, 4, 6
Key Differences
- Apixaban is a direct factor Xa inhibitor, while aspirin is an antiplatelet agent 4, 6
- Apixaban has been shown to be more effective than aspirin in preventing stroke or systemic embolism in certain patient populations 2, 3, 5
- Apixaban does not require regular monitoring of anticoagulation intensity, while aspirin may require monitoring of platelet function 4, 6