Efficacy and Safety of Apixaban Versus Warfarin in LVAD Patients: A Propensity-Matched Analysis
1
INTERNAL MEDICINE DEPARTMENT, HACKENSACK MERIDIAN OCEAN UNIVERSITY MEDICAL CENTER, BALTIMORE, UNITED STATES
2
INTERNAL MEDICINE DEPARTMENT, ASCENSION SAINT AGNES HOSPITAL, BRICK TOWNSHIP, UNITED STATES
3
INTERNAL MEDICINE DEPARTMENT, KING ABDULLAH UNIVERSITY HOSPITAL, IRBID, JORDAN
4
INTERNAL MEDICINE DEPARTMENT, UNIVERSITY OF MARYLAND MIDTOWN CAMPUS, BALTIMORE, UNITED STATES
5
INTERNAL MEDICINE DEPARTMENT, JORDAN MINISTRY OF HEALTH, JORDAN
Publication date: 2026-05-29
Corresponding author
Abdallah Al-Muhtaseb
Internal Medicine Department, Ascension Saint Agnes Hospital, Baltimore, MD, United States
Internal Medicine Department, Ascension Saint Agnes Hospital, Baltimore, MD, United States
Wiadomości Lekarskie 2026;(5):978-988
KEYWORDS
Left Ventricular Assist Device (LVAD)Heart Failure with Reduced Ejection Fraction (HFrEF)anticoagulationApixabanWarfarin
TOPICS
ABSTRACT
Introduction:
Aim: The primary endpoint was the incidence of major HRAEs. Secondary endpoints included LVAD thrombosis, stroke, major bleeding, non–central nervous system thromboembolism, and all-cause mortality.
Material and Methods:
We conducted a multicenter retrospective cohort study using the TriNetX database, identifying LVAD patients receiving either warfarin or apixaban. Two cohorts were established based on anticoagulation regimen, and propensity score matching was employed to minimize baseline differences.
Results:
After matching, 3,129 patients were included in each group. HRAEs occurred less frequently in the apixaban cohort (19.7%) than in the warfarin cohort (28.4%) (OR: 0.618; 95% CI: 0.513–0.744; P < 0.001). Apixaban was also associated with significantly fewer LVAD thrombosis events (OR: 0.088), strokes (OR: 0.721), and major bleeding events (OR: 0.528). Rates of non-CNS thromboembolism and all-cause mortality were similar between groups.
Conclusions:
Although warfarin remains the standard anticoagulant for LVAD recipients, apixaban demonstrated lower rates of major adverse events in this large retrospective analysis. Further prospective and randomized studies are warranted to confirm these findings and inform future clinical practice.
Aim: The primary endpoint was the incidence of major HRAEs. Secondary endpoints included LVAD thrombosis, stroke, major bleeding, non–central nervous system thromboembolism, and all-cause mortality.
Material and Methods:
We conducted a multicenter retrospective cohort study using the TriNetX database, identifying LVAD patients receiving either warfarin or apixaban. Two cohorts were established based on anticoagulation regimen, and propensity score matching was employed to minimize baseline differences.
Results:
After matching, 3,129 patients were included in each group. HRAEs occurred less frequently in the apixaban cohort (19.7%) than in the warfarin cohort (28.4%) (OR: 0.618; 95% CI: 0.513–0.744; P < 0.001). Apixaban was also associated with significantly fewer LVAD thrombosis events (OR: 0.088), strokes (OR: 0.721), and major bleeding events (OR: 0.528). Rates of non-CNS thromboembolism and all-cause mortality were similar between groups.
Conclusions:
Although warfarin remains the standard anticoagulant for LVAD recipients, apixaban demonstrated lower rates of major adverse events in this large retrospective analysis. Further prospective and randomized studies are warranted to confirm these findings and inform future clinical practice.
| eISSN: | 2719-342X |
| ISSN: | 0043-5147 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
