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The study demonstrated that apixaban 5 mg twice daily compared with warfarin was associated with a lower risk of stroke or systemic embolism, caused less bleeding including ICH, and resulted in lower mortality.In this pre-specified subgroup analysis of the ARISTOTLE trial, we assessed the efficacy and safety of apixaban compared with warfarin according to age.The risk of bleeding including intracranial haemorrhage (ICH) increases with age, and as such is a variable in the HASBLED bleeding risk score (assigning one point each for hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio (INR), elderly Recently, compared with warfarin, novel oral anticoagulants have been shown to be at least as good at reducing stroke and result in lower rate of ICH, with less drug and food interactions and no need for coagulation monitoring.The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial compared apixaban (a novel oral direct factor Xa inhibitor) with warfarin for the prevention of stroke or systemic embolism in patients with AF and at least one additional risk factor for stroke.The details of the ARISTOTLE trial have been published previously.

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0.13% per year in patients ≥75 years (HR 0.33, CI 0.13–0.82)] (interaction with continuous age, = 0.18).The risk of stroke in patients with atrial fibrillation (AF) increases with age.In the ARISTOTLE trial, apixaban when compared with warfarin reduced the rate of stroke, death, and bleeding.We evaluated these outcomes in relation to patient age.A total of 18 201 patients with AF and a raised risk of stroke were randomized to warfarin or apixaban 5 mg b.d. or placebo in 831 patients with ≥2 of the following criteria: age ≥80 years, body weight ≤60 kg, or creatinine ≥133 μmol/L.

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