Journal Article

Rivaroxaban in Patients with a Recent Acute Coronary Syndrome

Verheugt, Freek W.A, Gibson, C. Michael, Cook-Bruns, Nancy, Bhatt, Deepak L, Burton, Paul, Plotnikov, Alexei N, Sun, Xiang, Mega, Jessica L, Fox, Keith A.A, Bassand, Jean-Pierre, Goto, Shinya, Bode, Christoph, Murphy, Sabina A, Schneider, David, Wiviott, Stephen D, Cohen, Marc, Braunwald, Eugene

2012

Overview

In patients with acute coronary syndromes, low doses of rivaroxaban were effective in reducing the primary end point of death from cardiovascular causes, myocardial infarction, or stroke. Rivaroxaban also reduced overall mortality, although there was more bleeding. After an acute coronary syndrome, patients remain at risk for recurrent cardiovascular events despite standard medical therapy, including long-term antiplatelet therapy with aspirin and an adenosine diphosphate–receptor inhibitor. This risk may be related in part to excess thrombin generation that persists beyond the acute presentation in such patients. 1 As a result, there has been interest in evaluating the role of oral anticoagulants after an acute coronary syndrome. Improved cardiovascular outcomes were reported for patients who were treated with the anticoagulant warfarin in addition to aspirin. 2 However, widespread use of long-term warfarin in such patients has been limited by challenges associated . . .

• Publisher: Massachusetts Medical Society
• Subject: Acute Coronary Syndrome - drug therapy / Acute coronary syndromes / Aged / Angina pectoris / Anticoagulants / Anticoagulants - administration & dosage / Anticoagulants - adverse effects / Anticoagulants - therapeutic use / Arteriosclerosis / Biological and medical sciences / Bleeding / Cardiology. Vascular system / Cardiovascular disease / Cardiovascular Diseases - epidemiology / Cardiovascular Diseases - mortality / Cardiovascular Diseases - prevention & control / Cerebral infarction / Coronary artery / Coronary heart disease / Death / Double-Blind Method / Drug Administration Schedule / Factor Xa Inhibitors / Female / General aspects / Heart / Heart attacks / Heart surgery / Hemorrhage / Hemorrhage - chemically induced / Hemorrhage - mortality / Humans / Incidence / Intracranial Hemorrhages - chemically induced / Kaplan-Meier Estimate / Male / Medical sciences / Middle Aged / Morpholines - administration & dosage / Morpholines - adverse effects / Morpholines - therapeutic use / Myocardial infarction / Myocarditis. Cardiomyopathies / Rivaroxaban / Secondary Prevention / Thiophenes - administration & dosage / Thiophenes - adverse effects / Thiophenes - therapeutic use / Thrombosis