Gurevitz C, Giladi E, Barsheshet A, et al. - For patients with non-valvular atrial fibrillation (NVAF) and renal impairment, apixaban at any dose is suggested as a reasonable alternative to warfarin, possibly associated with improved outcomes.

• In this multicenter prospective cohort study, consecutive eligible apixaban or warfarin-treated patients with NVAF and renal impairment were followed-up for clinical events over a mean period of 1 year.

• Among the study population (n = 2,140), the high dose apixaban group showed significantly lower risk of composite outcome of 1-year mortality, stroke or systemic embolism, major bleeding and myocardial infarction, relative to the low dose group and the warfarin group.

• There were similar results of 1-year mortality.

• Propensity score analysis revealed a trend towards better composite outcome and mortality among patients treated appropriately with low-dose apixaban relative to 1:1 matched warfarin treated patients.

• Overall, significantly better outcomes were recorded for appropriately dosed apixaban treated patients at any dose relative to matched warfarin treated patients.