From the Research
The CHANCE protocol is not directly related to the provided evidence, which focuses on anticoagulation therapy for stroke prevention in patients with atrial fibrillation. However, based on the general concept of stroke prevention,
- the most effective strategy for reducing the risk of recurrent stroke is to use anticoagulant therapy, such as apixaban, which has been shown to be superior to warfarin in preventing stroke or systemic embolism, with a lower risk of bleeding and mortality 1.
- The choice of anticoagulant should be made by careful consideration of the benefit-to-risk ratio, taking into account the patient's underlying stroke and bleeding risk profile 2, 3.
- The use of direct oral anticoagulants (DOACs) such as apixaban, dabigatran, edoxaban, and rivaroxaban, can help mitigate the need for periodic monitoring of International Normalized Ratio (INR) and adverse bleeding events associated with the use of anti-vitamin K (AVK) anticoagulants like warfarin 4, 3.
- A study published in 2021 found that apixaban had a lower rate of stroke and psychiatric illness compared to acenocumarol, and non-valvular AF patients on apixaban had lower rates of thromboembolic events than those on acenocumarol 3.
- Therefore, apixaban is a recommended anticoagulant for stroke prevention in patients with atrial fibrillation, due to its efficacy and safety profile.