Abstract 16238: Apixaban versus Warfarin in the Evaluation of Progression of Atherosclerotic Calcification and Vulnerable Plaque (A Prospective Randomized Trial)

Background: Warfarin, a vitamin K antagonist (VKA) and one of the most commonly used anticoagulants, has been showed to increase vascular calcification leading to increased cardiovascular (CV) events. However, Apixaban, a Factor Xa inhibitor, has no interaction with vitamin K and its effect on progression of atherosclerotic plaques is still unknown. We aimed to compare Apixaban with Warfarin in progression of coronary plaque composition in non-valvular atrial fibrillation patients using coronary CT angiography (CCTA). Methods: This study is a prospective, single-center, randomized, open label study. A total of 56 subjects (69 % male with mean age at 57 years) who were enrolled and randomized to Apixaban (Api_grp) [46%] or Warfarin (VKA_grp) [54%] completed baseline and 1-year CCTA studies. Coronary plaque (total, calcified, non-calcified including fibrous, fibrofatty and low attenuation plaque [LAP]) volume normalized by total coronary artery length were measured using semi-automated software. The differe...