Rivaroxaban and stroke prevention in patients with atrial fibrillation: new evidence

Expert Rev Cardiovasc Ther. 2014 Aug;12(8):933-47. doi: 10.1586/14779072.2014.931223. Epub 2014 Jun 19.

Abstract

In the majority of patients with non-valvular atrial fibrillation (AF) anticoagulation is required to reduce the risk of stroke. Although vitamin K antagonists effectively reduce the risk of stroke, they have many disadvantages that limit their use. Rivaroxaban is a new once-daily oral anticoagulant that overcomes some of these limitations (i.e., no monitoring of anticoagulant effect required and fixed doses can be prescribed). In recent AF studies, rivaroxaban was reported to be at least as effective as warfarin for the prevention of stroke or systemic embolism but with a lesser risk of fatal bleeding and intracranial hemorrhage. More recent data have confirmed the beneficial effects of rivaroxaban, as originally described, and irrespective of the history of previous stroke, heart failure, myocardial infarction, diabetes, moderate renal dysfunction or age. In the present review the authors discuss current evidence regarding the efficacy and safety of rivaroxaban in patients with non-valvular AF.

Keywords: ROCKET-AF; anticoagulation; antithrombotic therapy; atrial fibrillation; bleeding; hemorrhage; rivaroxaban; stroke.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Oral
  • Animals
  • Anticoagulants / adverse effects
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy*
  • Factor Xa Inhibitors / administration & dosage
  • Factor Xa Inhibitors / adverse effects
  • Factor Xa Inhibitors / therapeutic use
  • Hemorrhage / chemically induced
  • Hemorrhage / prevention & control
  • Humans
  • Morpholines / administration & dosage
  • Morpholines / adverse effects
  • Morpholines / therapeutic use*
  • Rivaroxaban
  • Stroke / etiology
  • Stroke / prevention & control*
  • Thiophenes / administration & dosage
  • Thiophenes / adverse effects
  • Thiophenes / therapeutic use*
  • Vitamin K / antagonists & inhibitors
  • Warfarin / adverse effects
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Factor Xa Inhibitors
  • Morpholines
  • Thiophenes
  • Vitamin K
  • Warfarin
  • Rivaroxaban