Real-world off-label apixaban dosing and clinical outcomes in patients with heart failure and end-stage kidney disease - PubMed
4 hours ago
- #end-stage kidney disease
- #apixaban dosing
- #heart failure
- Study examines real-world off-label apixaban dosing in patients with heart failure (HF), nonvalvular atrial fibrillation (NVAF), and end-stage kidney disease (ESKD).
- Among 480 patients, 55.2% received an off-label underdose; baseline characteristics (CHA2DS2-VASc, HAS-BLED) were similar across dosing groups.
- Over a median 48-month follow-up, no significant differences in systemic thromboembolic events, mortality, or bleeding risk were found between underdose, standard dose, or overdose groups.
- Multivariate analysis identified CHA2DS2-VASc score as an independent predictor of thromboembolic events (OR 1.818, 95% CI 1.081-3.058, P=0.024).
- Off-label apixaban dosing was not associated with increased risks, suggesting potential for personalized dosing based on patient-specific factors, especially in Asian populations.