{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T20:44:06Z","timestamp":1760042646850,"version":"3.43.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008903","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["HC21C0028"],"award-info":[{"award-number":["HC21C0028"]}],"id":[{"id":"10.13039\/100008903","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019266","name":"Korea Medical Device Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["HI20C1662","1711138358","KMDF_PR_20200901_0173"],"award-info":[{"award-number":["HI20C1662","1711138358","KMDF_PR_20200901_0173"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This study, using a prospective cohort, evaluated the effectiveness and safety of off-label reduced-dose apixaban vs. the on-label dose in atrial fibrillation (AF) patients meeting a single-dose reduction criterion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The efficAcy and Safety of aPixaban In REal-world practice in Korean frail patients with AF (ASPIRE) study is a multicentre, prospective observational cohort involving AF patients who met a single-dose reduction criterion of apixaban. Patients were divided into two groups: an on-label standard dose (5\u00a0mg twice daily) and an off-label reduced dose (2.5\u00a0mg twice daily). The primary effectiveness outcome was stroke\/systemic embolism (SSE), and the primary safety outcome was major bleeding. Of 1944 patients (mean age 74.3\u00a0\u00b1\u00a07.9 years, 56% women), 997 (51%) were receiving off-label reduced-dose apixaban. The off-label reduced-dose group was older, had more comorbidities, higher concomitant antiplatelet use, and higher CHA2DS2\u2013VASc and HAS-BLED scores. During follow-up (1.0\u00a0\u00b1\u00a00.2 year), crude incidence rates were 0.9\u00a0vs. 0.7 per 100 person-years for SSE and 0.5\u00a0vs. 1.0 for major bleeding in the on-label vs. off-label groups. After inverse probability of treatment weighting, the off-label reduced-dose group showed no significant differences in the risk of SSE [hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.28\u20131.59, P\u00a0=\u00a00.370] and major bleeding (HR 1.38, 95% CI 0.44\u20134.35, P\u00a0=\u00a00.578) compared with the on-label standard dose group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In Korean patients with AF meeting a single-dose reduction criterion of apixaban, off-label reduced-dose apixaban showed no significant differences in SSE and major bleeding compared with the on-label standard dose. These findings suggest that individualized anticoagulation strategies, such as reduced-dose apixaban, may be beneficial for patients with a high risk of bleeding.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvaf018","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T08:35:47Z","timestamp":1742286947000},"page":"403-411","source":"Crossref","is-referenced-by-count":2,"title":["Apixaban outcomes in atrial fibrillation patients with a single-dose reduction criterion: ASPIRE 1-year results"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6351-5015","authenticated-orcid":false,"given":"So-Ryoung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital , 101, Daehak-ro, Jongno-gu, Seoul 03080 ,","place":["Republic of Korea"]},{"name":"Department of Internal Medicine, Seoul National University College of Medicine , 103, Daehak-ro, Jongno-gu, Seoul 03080 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JungMin","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital , 101, Daehak-ro, Jongno-gu, Seoul 03080 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-6855","authenticated-orcid":false,"given":"Soonil","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital , 101, Daehak-ro, Jongno-gu, Seoul 03080 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-0378","authenticated-orcid":false,"given":"Hyo-Jeong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital , 101, Daehak-ro, Jongno-gu, Seoul 03080 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6458-6130","authenticated-orcid":false,"given":"Kyung-Yeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Hospital , 101, Daehak-ro, Jongno-gu, Seoul 03080 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong-Il","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, Korea University College of Medicine and Korea University Anam Hospital , Seoul 02841 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine , Seoul 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