{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:42:05Z","timestamp":1785822125422,"version":"3.56.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess whether rivaroxaban is associated with a decreased risk of major adverse limb events (MALE), stroke, systemic embolism (SE), and major bleeding (MB) among patients with non-valvular atrial fibrillation (NVAF) and peripheral artery disease (PAD), compared with apixaban.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a population-based cohort study using the UK Clinical Practice Research Datalink. Patients aged \u226545 years with incident NVAF and PAD who initiated rivaroxaban or apixaban between 2013 and 2021 were included. Primary effectiveness outcomes were MALE, and a composite of ischaemic stroke, transient ischaemic attack (TIA), or SE. The primary safety outcome was MB. The risk of major cardiovascular events (MACE) was assessed as a secondary outcome. Confounding was addressed using propensity score fine stratification and weighting. Weighted Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). The cohort included 6170 new users of rivaroxaban and 9990 new users of apixaban (44% female; mean [SD] age 78.5 [9.2] years). Incidence rates were similar for MALE (6.7 vs. 5.6\/1000 person-years; adjusted HR (aHR): 1.20; 95% CI 0.87\u20131.65), stroke\/TIA\/SE (24.5 vs. 21.3\/1000 person-years; aHR: 1.15; 95% CI 0.97\u20131.36), and MACE (40.1 vs. 35.9 per 1000 person-years; aHR 1.10: 95% CI 0.94\u20131.28). Major bleeding rates were higher with rivaroxaban (46.1 vs. 29.8\/1000 person-years; aHR: 1.55; 95% CI 1.36\u20131.77).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with NVAF and PAD, rivaroxaban was associated with a similar risk of MALE and stroke\/TIA\/SE, but a higher risk of MB compared with apixaban. These findings support apixaban as a potentially safer anticoagulant in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvaf063","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T11:33:41Z","timestamp":1755603221000},"page":"664-673","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness and safety of rivaroxaban vs. apixaban in patients with atrial fibrillation and peripheral artery disease"],"prefix":"10.1093","volume":"11","author":[{"given":"Loubna","family":"Dari","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University , 2001 Av. McGill College, Montreal, QC H3A 1Y7 ,","place":["Canada"]},{"name":"Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital , 3755 C\u00f4te Sainte Catherine H 416.1, Montreal, QC H3T 1E2 ,","place":["Canada"]},{"name":"Department of Vascular Medicine, Bordeaux University Hospital , 1 rue Jean Burguet, 33000 Bordeaux ,","place":["France"]},{"name":"Bordeaux Population Health, Inserm Unit 1219 , 146 rue L\u00e9o Saignat, 33000 Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Beradid","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital , 3755 C\u00f4te Sainte Catherine H 416.1, Montreal, QC H3T 1E2 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00ebl","family":"Constans","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Bordeaux University Hospital , 1 rue Jean Burguet, 33000 Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7873-5483","authenticated-orcid":false,"given":"Antoine","family":"Pariente","sequence":"additional","affiliation":[{"name":"Bordeaux Population Health, Inserm Unit 1219 , 146 rue L\u00e9o Saignat, 33000 Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4691-9579","authenticated-orcid":false,"given":"Christel","family":"Renoux","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University , 2001 Av. McGill College, Montreal, QC H3A 1Y7 ,","place":["Canada"]},{"name":"Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital , 3755 C\u00f4te Sainte Catherine H 416.1, Montreal, QC H3T 1E2 ,","place":["Canada"]},{"name":"Department of Medicine, McGill University , Montreal, QC H3G 2M1 ,","place":["Canada"]},{"name":"Department of Neurology and Neurosurgery, McGill University , Montreal, QC H3A 1A1 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,30]]},"reference":[{"key":"2025121518521575700_pvaf063-B1","doi-asserted-by":"crossref","first-page":"ehaa946.2366","DOI":"10.1093\/ehjci\/ehaa946.2366","article-title":"Atrial fibrillation in a cohort of patients with peripheral arterial disease. A retrospective study of a healthcare database in UK","volume":"41","author":"Vitalis","year":"2020","journal-title":"Eur Heart J"},{"key":"2025121518521575700_pvaf063-B2","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. 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