COmparison of Bleeding Risk Between Rivaroxaban and Apixaban in Patients With Atrial Fibrillation (COBRRA-AF)
Atrial Fibrillation
About this trial
This is an interventional treatment trial for Atrial Fibrillation focused on measuring Stroke Prevention, Bleed
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years old
- Confirmed new diagnosis of AF on ECG with an indication to start anticoagulation according to Canadian Cardiovascular Society guidelines
Exclusion Criteria:
- Creatinine clearance =<15 ml/min calculated using the Cockcroft-Gault formula
Any contraindication for anticoagulation with apixaban or rivaroxaban as determined by the treating physician such as, but not limited to:
- active bleeding
- history of mechanical valve
- other indication for anticoagulation (e.g. mechanical valves, venous thrombosis)
- dual antiplatelet agent use
- known liver disease with coagulopathy
- use of contraindicated medications (strong inducers/inhibitors of CYP 3A4/5, P-glycoprotein)
- pregnancy or breastfeeding
Sites / Locations
- QEII Health Science Centre
- Kingston General HospitalRecruiting
- The Ottawa Hospital - General CampusRecruiting
- University Ottawa Heart InstituteRecruiting
- Université Laval
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Apixaban group
Rivaroxaban Group
5 mg PO, twice daily for 12 months of treatment. A dose reduction* to 2.5 mg twice daily will apply if patients meet 2 of 3 following criteria: age > 80 years; weight < 60 kg; creatinine >133 micromol/L. *Patients with AF who are receiving DOAC should have their renal function assessed at baseline and at least annually
20 mg PO, once daily for 12 months of treatment. A dose reduction* to 15 mg daily will apply to patients with creatinine clearance <50 ml/min. *Patients with AF who are receiving DOAC should have their renal function assessed at baseline and at least annually