Most Read Articles
Pearl Toh, 12 Sep 2020
Early initiation of rhythm-control therapy led to a significantly reduced risk of major adverse cardiovascular (CV) outcomes compared with usual care (typically rate control) in patients with newly diagnosed atrial fibrillation (AF) at risk of stroke, reveals the EAST-AFNET 4* trial presented at ESC 2020.
Audrey Abella, 16 Sep 2020
The final results of EVAPORATE* reinforce the plaque-regressing potential of icosapent ethyl (IPE) in patients on statins for elevated triglycerides.

Rivaroxaban safely treats NVAF in those with worsening renal function

14 Oct 2019

Rivaroxaban is mostly safe for the treatment of nonvalvular atrial fibrillation (NVAF) in patients with worsening renal function (WRF), a recent study has found.

 This sub-analysis of the Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS) included 7,509 patients who completed the 1-year follow-up and for whom change in creatinine clearance could be measured. WRF was defined as a decrease in clearance rate of at least 20 percent from enrolment to any time point.

Of the participants, 1,229 met the criteria for WRF (mean age, 75.0±9.6 years; 43.6 percent female), while the remaining 6,280 had stable renal function (SRF; mean age, 72.9±9.5 years; 36.9 percent female). Majority (55 percent) of those with WRF received 15-mg once-daily (od) doses of rivaroxaban, while the others were underdosed, at 10 mg od.

Over a mean treatment duration of 316±102 days, 85 bleeding events were reported in the WRF group. This corresponded to an incidence rate of 8.1 per 100 patient-years, which was not significantly different than that in their SRF counterparts (hazard ratio [HR], 1.12, 95 percent CI, 0.88–1.41; p=0.350). At the 1-year follow-up, 66.9 percent of the WRF group were still on rivaroxaban treatment, 13.0 percent discontinued, and 20.1 percent were lost to follow-up.

Of all types of bleeding events, only the need for transfusion of 2 units of packed red blood cells or whole blood was significantly greater in the WRF group (HR, 3.19, 1.04–9.74; p=0.032). Mortality risk was also significantly elevated as compared to SRF patients (HR, 2.29, 1.62–3.24; p<0.001).

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Most Read Articles
Pearl Toh, 12 Sep 2020
Early initiation of rhythm-control therapy led to a significantly reduced risk of major adverse cardiovascular (CV) outcomes compared with usual care (typically rate control) in patients with newly diagnosed atrial fibrillation (AF) at risk of stroke, reveals the EAST-AFNET 4* trial presented at ESC 2020.
Audrey Abella, 16 Sep 2020
The final results of EVAPORATE* reinforce the plaque-regressing potential of icosapent ethyl (IPE) in patients on statins for elevated triglycerides.