Rivaroxaban: A Review for Secondary CV Prevention in CAD and PAD

Scott, Lesley J.

doi:10.1007/s40265-020-01397-7

Cited by 10 publications

(5 citation statements)

References 42 publications

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“…Rivaroxaban is a direct factor Xa inhibitor that has advantages over warfarin in terms of efficacy Available at www.veterinaryworld.org/Vol.17/April-2024/8.pdf and safety in diseases with a high risk of thromboembolism. Inhibition of factor Xa by low-dose rivaroxaban improves cardiovascular outcomes in human medicine rivaroxaban has advantages such as rapid onset of action, predictable efficacy, and no need for routine coagulation monitoring [31,32]. In a previous study, rivaroxaban 15 mg once daily plus clopidogrel was shown to be a feasible treatment strategy for cats.…”

Section: Discussionmentioning

confidence: 99%

Rivaroxaban versus enoxaparin plus clopidogrel therapy for hypertrophic cardiomyopathy-associated thromboembolism in cats

Jaturanratsamee,

Jiwaganont,

Panprom

et al. 2024

Vet World

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Background and Aim: Cardiogenic embolism (CE) is a common complication of feline hypertrophic cardiomyopathy (HCM), leading to severe clinical symptoms. This study compared the effects of rivaroxaban and enoxaparin combined with clopidogrel on cats. Materials and Methods: This was a single-center, prospective, randomized controlled trial. In this study, rivaroxaban or enoxaparin plus clopidogrel was prescribed to 23 cats for at least one of the following events: Abnormal movement of the anterior mitral leaflet during systole, enlargement of the left atrium, spontaneous echocardiographic contrast, or presence of arterial thromboembolism. Oral rivaroxaban (2.5 mg, q24 h) was prescribed to six cats. Subcutaneous injections of enoxaparin (1 mg/kg, q24 h) plus oral clopidogrel (3 mg/kg, PO q24 h) for 60 days were administered to 17 cats. Renal insufficiency and bleeding complications were observed. Plasma concentrations of D-dimer, prothrombin time (PT), partial thromboplastin time, and international normalized ratio (INR) were evaluated. We analyzed the relationship between echocardiography parameters and the effects of coagulation. Blood samples were collected from all cats at baseline and at 1 and 2 months post-treatment. Results: Rivaroxaban alone and in combination with enoxaparin and clopidogrel significantly affected PT and INR. In cats treated with 2.5 mg/kg rivaroxaban for 60 days, no bleeding or recurrence of thrombus formation was observed. These data support the use of rivaroxaban for the treatment of HCM-associated thromboembolism in cats. Conclusion: Treatment of HCM-associated thromboembolism with rivaroxaban alone demonstrated clinical effectiveness with no clinical complications in cats. Keywords: cardiomyopathy, D-dimer, echocardiography, prothrombin time.

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Section: Discussionmentioning

confidence: 99%

Rivaroxaban versus enoxaparin plus clopidogrel therapy for hypertrophic cardiomyopathy-associated thromboembolism in cats

Jaturanratsamee,

Jiwaganont,

Panprom

et al. 2024

Vet World

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“…Moreover, the incidence of a first episode of DVT or PE in patients aged over 80 years old is estimated to be 6 times higher than that in patients less than 50 years of age. Due to the better benefit-risk profile in comparison with VAKs, rivaroxaban is recommended in the daily clinical treatment of geriatric patients for anticoagulation therapy [ 11 – 15 ]. However, hemorrhagic events, as one of the major side effects caused by rivaroxaban, pose a great threat to patient health.…”

Section: Discussionmentioning

confidence: 99%

“…As the first approved factor Xa inhibitor among DOACs, rivaroxaban has been widely used in the treatment of patients with nonvalvular atrial fibrillation (NVAF) to reduce the risk of stroke and systemic embolism, in the prevention of venous thromboembolism (VTE) in adult patients undergoing elective hip or knee replacement surgery, and in prophylaxis of recurrent acute deep venous thrombosis (DVT) and pulmonary embolism (PE) [ 11 – 15 ]. Some studies have shown that DOACs represented by rivaroxaban exhibited significantly lower mortality and intracranial hemorrhage than VAKs.…”

Section: Introductionmentioning

confidence: 99%

XGBoost-based machine learning test improves the accuracy of hemorrhage prediction among geriatric patients with long-term administration of rivaroxaban

et al. 2023

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Background Hemorrhage is a potential and serious adverse drug reaction, especially for geriatric patients with long-term administration of rivaroxaban. It is essential to establish an effective model for predicting bleeding events, which could improve the safety of rivaroxaban use in clinical practice. Methods The hemorrhage information of 798 geriatric patients (over the age of 70 years) who needed long-term administration of rivaroxaban for anticoagulation therapy was constantly tracked and recorded through a well-established clinical follow-up system. Relying on the 27 collected clinical indicators of these patients, conventional logistic regression analysis, random forest and XGBoost-based machine learning approaches were applied to analyze the hemorrhagic risk factors and establish the corresponding prediction models. Furthermore, the performance of the models was tested and compared by the area under curve (AUC) of the receiver operating characteristic (ROC) curve. Results A total of 112 patients (14.0%) had bleeding adverse events after treatment with rivaroxaban for more than 3 months. Among them, 96 patients had gastrointestinal and intracranial hemorrhage during treatment, which accounted for 83.18% of the total hemorrhagic events. The logistic regression, random forest and XGBoost models were established with AUCs of 0.679, 0.672 and 0.776, respectively. The XGBoost model showed the best predictive performance in terms of discrimination, accuracy and calibration among all the models. Conclusion An XGBoost-based model with good discrimination and accuracy was built to predict the hemorrhage risk of rivaroxaban, which will facilitate individualized treatment for geriatric patients.

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“…Since factor Xa plays a central role in thrombosis, inhibition of factor Xa with low-dose rivaroxaban might improve cardiovascular outcomes in patients with recent ACS. It has the advantages of rapid onset of action, predictable efficacy, no need for routine coagulation monitoring, and conventional-dose adjustment [21,22]. Dual antithrombotic therapy with rivaroxaban 15 mg once daily plus clopidogrel is a feasible treatment strategy among patients undergoing PCI with AF in the PIONEER AF-PCI trial [10].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with coronary atherosclerotic heart disease and gastrointestinal disease undergoing percutaneous coronary intervention: study protocol for a non-inferiority randomized controlled trial

Zhou

Gong

et al. 2023

Trials

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Background Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is recommended for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) to antithrombosis, meanwhile, increasing the risks of gastrointestinal bleeding. Rivaroxaban, a novel oral anticoagulant, combined with a P2Y12 receptor inhibitor reduces adverse events in patients with CHD and atrial fibrillation who underwent PCI. The effect of rivaroxaban plus P2Y12 inhibitor on reducing bleeding events in patients with CHD and gastrointestinal disease (GID) undergoing PCI remains unclear. Method The study is a prospective, single-center, randomized controlled trial. A total of 1020 patients with CHD and GID undergoing PCI will be enrolled. Patients are randomized (1:1) to receive either rivaroxaban 10 mg plus clopidogrel 75 mg daily or aspirin 100 mg plus clopidogrel 75 mg daily; both treatments will last 6 months. The primary endpoint is Bleeding Academic Research Consortium (BARC) type 2–5 bleeding requiring medical intervention. The secondary endpoint is a composite of major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, cardiac death, nonfatal myocardial infarction, stent thrombosis, ischemia-driven target vessel revascularization, and stroke. Discussion The objective of this study is to evaluate the efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with CHD and GID undergoing PCI. We aim to explore an optimized antithrombotic strategy, which achieves the same anti-ischemic effect as standard DAPT without increasing the risk of GIB, for patients with CHD and GID undergoing PCI. Trial registration This protocol is registered at the Chinese Clinical Trial Registry under the number ChiCTR2100044319. And this publication is based on version 1.4 of the trial protocol dated Sep 6, 2021.

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Rivaroxaban: A Review for Secondary CV Prevention in CAD and PAD

Cited by 10 publications

References 42 publications

Rivaroxaban versus enoxaparin plus clopidogrel therapy for hypertrophic cardiomyopathy-associated thromboembolism in cats

Rivaroxaban versus enoxaparin plus clopidogrel therapy for hypertrophic cardiomyopathy-associated thromboembolism in cats

XGBoost-based machine learning test improves the accuracy of hemorrhage prediction among geriatric patients with long-term administration of rivaroxaban

Efficacy and safety of rivaroxaban plus clopidogrel versus aspirin plus clopidogrel in patients with coronary atherosclerotic heart disease and gastrointestinal disease undergoing percutaneous coronary intervention: study protocol for a non-inferiority randomized controlled trial

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