Are You Happy Now? Satisfaction of Patients on LVAD Switched from Warfarin to Direct Oral Anticoagulation (DOAC). First Result of the Apixivad Study.

The ApixiVad study aims to test the non-inferiority of Apixaban compared to oral anticoagulation with Warfarin in patients supported by an LVAD. A secondary outcome is to test patient satisfaction according to the type of anticoagulation. Patients followed at our institution are randomised to maintain warfarin therapy or to switch to Apixaban. On the day of randomisation and follow-up, patients were asked to complete a satisfaction questionary regarding anticoagulation, the Anti-Clot-Treatment Satisfaction (ACTS). Of the first 13 patients randomised, only one was female (1/13, 3.5%), median age 45 (50-59), and all were implanted as BTT with a HeartMade 3. At the time of randomisation, the patients had been on LVAD for a median of 3.6 months (3.1-4.5); 8 were randomised to the apixaban group and 5 to the Warfarin group. The burden related to anticoagulation decreased after the switch to Apixaban, from a score of 18.5/60 to 15.5/60, whereas the patients on Marcoumar saw their burden increase from a score of 19.4/60 to 23.8/60 (Illustration, Panel A). The satisfaction with anticoagulation was not different between the two groups (illustration, Panel B). When looking at the response to the questionnaire in detail, the improvement in the score of Apixaban patients is due to the simplification of the drug administration (Figure, Panel C). The quality of life, measured by the ACTS questionnaire, increases in patients with LVAD switching from Warfarin to Apixaban. [ABSTRACT FROM AUTHOR]