title: Efficacy and safety of apixaban in the patients undergoing the ablation of atrial fibrillation.
abstract: BACKGROUND
  Apixaban, a factor Xa (FXa) inhibitor, is a new oral anticoagulant for stroke prevention in atrial fibrillation (AF). However, little is known about its efficacy and safety as a periprocedural anticoagulant therapy for patients who had undergone catheter ablation (CA) for AF.
  
  
  RESULTS
  We evaluated 342 consecutive patients who underwent CA for AF between April 2013 and March 2014 and received apixaban (n = 105) and warfarin (n = 237) for uninterrupted periprocedural anticoagulation. We retrospectively investigated the occurrence of bleeding and thromboembolic complications during the procedural period and compared them between the apixaban group (AG) and warfarin group (WG). Thromboembolic complications occurred in one (0.4%) patient in the WG. Major and minor bleeding complications occurred in one (1%) and four (4%) patients in the AG, and three (1%) and 12 (5%) patients in the WG. No significant difference in complications was observed between the AG and WG. Of importance, adverse event rates did not differ between the two groups after adjusting by a propensity score analysis. In preoperative tests of blood coagulation, there were significant differences in the prothrombin time, activated partial thromboplastin time, FXa activity, and prothrombin fragment 1 + 2 (F1+2) levels between the AG and WG.
  
  
  CONCLUSIONS
  The use of apixaban during the periprocedural period of AF ablation seemed as efficacious and safe as warfarin.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nagao
authors.forename: Yasuya
authors.initials: Y
authors.lastname: Inden
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimano
authors.forename: Masaya
authors.initials: M
authors.lastname: Fujita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yanagisawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Shinji
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Aya
authors.initials: A
authors.lastname: Miyoshi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okumura
authors.forename: Shiou
authors.initials: S
authors.lastname: Ohguchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshida
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirai
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D011292:Premedication; D011720:Pyrazoles / Q000008:administration & dosage* / Q000009:adverse effects*; D011728:Pyridones / Q000008:administration & dosage* / Q000009:adverse effects*; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D014859:Warfarin
keywords: apixaban; atrial fibrillation; catheter ablation