Akao M, et al. - Given apixaban has been shown efficacious as well as safe as a prophylactic for stroke in patients with atrial fibrillation (AF) investigated in randomized clinical trials, but there exists limited data on patients with low creatinine clearance (CCr), particularly CCr 15–29 mL/min, so, researchers performed a sub-analysis of a large-scale, multicenter prospective observational study, the J-ELD AF Registry, including Japanese non-valvular AF patients aged ≥ 75 years receiving on-label dose (standard dose of 5 mg BID or reduced dose of 2.5 mg BID) of apixaban. Three CCr subgroups of the whole cohort (3,015 patients from 110 institutions) were defined: CCr ≥ 50 mL/min, CCr 30–49 mL/min, and CCr 15–29 mL/min. For stroke or systemic embolism and bleeding necessitating hospitalization, the reported incidence of events in each CCr value group was found to be comparable, but only in the CCr 15–29 mL/min group, it was significantly higher for total deaths and cardiovascular deaths, among Japanese non-valvular AF patients aged ≥75 years.