Safety and efficacy of rivaroxaban vs. vitamin K antagonists in patients with atrial fibrillation: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials - PubMed
8 hours ago
- #Rivaroxaban
- #Atrial Fibrillation
- #Vitamin K Antagonists
- Rivaroxaban, a direct oral anticoagulant (DOAC), is compared to vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF).
- AF increases stroke risk fivefold, necessitating anticoagulation therapy.
- A systematic review and meta-analysis of four RCTs (n=17,634) was conducted, with 56.4% on rivaroxaban and 43.6% on VKAs.
- Rivaroxaban significantly reduces risks of hemorrhagic stroke, systemic embolism, fatal bleeding, and intracranial bleeding compared to VKAs.
- No significant differences were found in ischemic stroke, myocardial infarction (MI), heart failure hospitalization, mortality, and major/minor bleeding outcomes.
- Rivaroxaban increases the risk of death from cardiac causes.
- Large-scale trials are needed to assess rivaroxaban's impact on ischemic stroke, death, and major/minor hemorrhage in AF patients.