In a subanalysis, the benefits Of Eliquis® (apixaban) vs. warfarin in reducing the risk of stroke in patients with nonvalvular atrial fibrillation were consistent, regardless of blood pressure control

Published on:

PRINCETON, N.J., & NEW YORK (March 27, 2014) -- Bristol-Myers Squibb Company (NYSE: BMY) and Pfizer Inc. (NYSE: PFE) today announced the results of a pre-specified subanalysis of the Phase 3 ARISTOTLE trial that assessed the effect of blood pressure control on outcomes as well as the treatment effect of Eliquis (apixaban) compared to warfarin according to blood pressure control.1 The results showed that poor blood pressure control was associated with a substantially higher risk of stroke or systemic embolism, independent of Eliquis or warfarin treatment. However, this subanalysis found consistent results for Eliquis versus warfarin in reducing the risk of stroke, regardless of blood pressure control. These data will be presented Saturday, March 29, at the American College of Cardiology’s (ACC) 63rd Annual Scientific Session in Washington, D.C.

“These data highlight the critical importance of blood pressure control in addition to anticoagulation in helping to lower the risk of stroke in patients with atrial fibrillation.”

“High blood pressure is a risk factor for stroke in patients with atrial fibrillation. In this analysis, poorly controlled blood pressure at any time during the trial increased the risk of stroke by approximately 50 percent. The results for apixaban compared to warfarin in reducing the risk of stroke were consistent regardless of blood pressure,” said study lead author Meena Rao, MD, MPH, Duke Clinical Research Institute at Duke University Medical Center. “These data highlight the critical importance of blood pressure control in addition to anticoagulation in helping to lower the risk of stroke in patients with atrial fibrillation.”

In ARISTOTLE, a total of 15,916 (87.5 percent) patients had a history of hypertension requiring treatment. During the trial, 50 percent of patients had poorly controlled hypertension (defined as systolic blood pressure > 140 mm Hg and/or diastolic blood pressure > 90 mm Hg) at some point. Poorly controlled hypertension during the course of the trial was associated with a significant 53 percent increase in the risk of stroke or systemic embolism. Eliquis was consistent in reducing the risk of stroke or systemic embolism versus warfarin in patients with and without poor blood pressure control during the trial (p for interaction = 0.97).1

In this subanalysis, the effect of Eliquis in reducing the risk of stroke and systemic embolism versus warfarin was consistent with the main results of the ARISTOTLE trial. Further, the effect of Eliquis in reducing the risk of stroke and systemic embolism versus warfarin was also consistent with the results of the ARISTOTLE trial in previously published subanalyses of other comorbidities, including congestive heart failure, advanced age, renal impairment and prior stroke.

A total of 11 Bristol-Myers Squibb/Pfizer alliance-sponsored abstracts, including this ARISTOTLE subanalysis, were accepted for presentation at the American College of Cardiology’s 63rd Annual Scientific Session.

Related Content

IVUS-guided PCI reduces risks in patients with diabetes
LAAC with Watchman FLX reduces bleeding risks after AFib ablation
Bioresorbable BTK stent superior to ballon angioplasty at 2 years
Shockwave Medical’s IVL technology delivers more positive outcomes for PAD patients
Standing desks fail to lower blood pressure or minimize heart risks—they may even do damage
IVL vs. RA for chronic total occlusion PCI: Key data cardiologists should know

Around the web

Health Imaging
Use of AI opportunistic screening in CT for cardiovascular disease

Ron Blankstein, MD, professor of radiology, Harvard Medical School, explains the use of artificial intelligence to detect heart disease in non-cardiac CT exams.

Health Imaging
New imaging protocols proposed to curb rise of cardiovascular infections

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

Radiology Business
What does radiology have to do with climate change?

Kate Hanneman, MD, explains why many vendors and hospitals want to lower radiology's impact on the environment. "Taking steps to reduce the carbon footprint in healthcare isn’t just an opportunity," she said. "It’s also a responsibility."