For patients with AF and valvular heart disease, apixaban is associated with a reduced risk for ischaemic stroke or systemic embolism and a reduced risk for bleeding compared with rivaroxaban, according to a study published in the Annals of Internal Medicine.

Ghadeer K Dawwas (PhD), from the University of Pennsylvania in Philadelphia, and colleagues emulated a target trial of effectiveness and safety of apixaban and rivaroxaban in patients with AF and valvular heart disease (VHD) in a new-user cohort study.

Data were obtained from a commercial health insurance database from 2013 to 2020.

The researchers found that apixaban was associated with a lower rate of ischaemic stroke or systemic embolism (hazard ratio, 0.57) and bleeding (hazard ratio, 0.51) compared with rivaroxaban in a propensity score-matched cohort of 19,894 patients (9947 receiving each drug).