Eliquis is a so-called Xa inhibitor, which is a class of anticoagulants that work by blocking factor X, a protein involved in blood clotting.
Over an average follow-up of eight months, 7.5 percent of the patients receiving Eliquis had a heart attack, suffered a stroke, or died, as did 7.9 percent of the patients receiving placebo, the researchers found.
In addition, 1.3 percent of those taking Eliquis had major bleeding, compared with 0.5 percent of those receiving the placebo, they noted.
Moreover, more patients taking Eliquis had bleeding into the brain and died from uncontrollable bleeding than patients receiving placebo, Alexander said.
Would a lower dose of Eliquis work? Alexander is skeptical. While it could reduce the risk of bleeding, he said he doubts more heart attacks, strokes or deaths would be prevented.
The trial was funded by Pfizer/Bristol-Myers Squibb, the makers of Eliquis.
Commenting on the study, Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said that "each year more than 1.4 million men and women are admitted to hospitals in the United States with acute coronary syndromes."
Despite conventional therapy, patients with acute coronary syndromes remain at risk for recurrent cardiovascular events, Fonarow said.
A number of medications that prevent blood clots (known as antithrombotic drugs) "are being evaluated in patients with acute coronary syndromes to determine if they can further reduce cardiovascular event risk without substantially increasing the bleeding risk when added to conventional therapies," he said.
Apixaban and two other drugs, rivaroxaban (Xarelto) and dabigatran (Pradaxa), have been shown to provide significant benefit in reducing stroke and clots in patients with atrial fibrillation, where the benefit outweighs the bleeding risk, Fonarow said.
"However, this new study suggests that the use of apixaban, at least at the dos
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