Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C


OBJECTIVE: The objective of this EBM review is to determine whether or not Apixaban is effective for the prevention of stroke in patients with non-valvular atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published all published in 2011.

DATA SOUCRES: Three double-blind randomized control trials found using the Cochrane Database and PubMed.

OUTCOME(S) MEASURED: Outcomes measured were occurrence of stroke (TIA or CVA), systemic embolism, major bleeding or clinically relevant non-major bleeding, and incidence of death.

RESULTS: Apixaban 2.5mg and 5mg were both superior to Warfarin in the prevention of stroke or systolic embolism and also decreased the rate of intracranial hemorrhage or other clinically relevant bleeding. Apixaban 5mg also demonstrated superiority compared to aspirin 81-324mg in reduction of stroke, systemic embolism, and death rates.

CONCLUSION: In patients with atrial fibrillation, apixaban was superior to both warfarin (adjusted to an INR 2.0-3.0) and aspirin (81-324mg) in the indication of prevention of stroke or systemic embolism.