OCEANIC-AF
PubMed • Full text • PDF • ClinicalTrials.gov
Clinical Question
Among patients with atrial fibrillation, how does the factor XIa inhibitor asundexian compare with the factor Xa inhibitor apixaban in terms of stroke, systemic embolism, and bleeding?
Bottom Line
Among patients with atrial fibrillation, the factor XIa inhibitor asundexian reduced rates of bleeding but increased the risk of stroke or systemic embolism compared with the factor Xa inhibitor apixaban.
Major Points
Conventional anticoagulation strategies are based on reducing hemostatic pathways in the blood, which necessarily increases bleeding risk. Recent advances suggest that thrombosis can be uncoupled from hemostasis through inhibition of particular coagulation factors. One such factor is factor XI, congenital deficiency of which does not increase the risk of bleeding, and which seems to play a larger role in pathologic thrombosis than in hemostasis. Inhibition of factor XI is therefore a potentially attractive strategy for anticoagulation in a wide range of disease states.
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