Which Anticoagulant for Atrial Fibrillation?
Which Anticoagulant for Atrial Fibrillation?
This is the Medscape Neurology Minute. I am Dr. Alan Jacobs. Researchers from Duke University's Clinical Research Institute have published a double-blind trial to determine whether rivaroxaban, an oral factor Xa inhibitor, provides more consistent and predictable anticoagulation than warfarin in patients with nonvalvular atrial fibrillation. A total of 14,264 patients were randomly assigned to receive either rivaroxaban 20 mg daily or dose-adjusted warfarin. The primary endpoint was whether rivaroxaban was noninferior to warfarin for the occurrence of stroke or systemic embolism. In the primary analysis, 188 patients in the rivaroxaban group and 241 in the warfarin group reached the primary endpoint. Major and nonmajor clinically relevant bleeding occurred in 14.9%/year in the rivaroxaban group and 14.5%/year in the warfarin group, with a significant reduction in intracranial hemorrhage and fatal bleeding in the rivaroxaban group. The investigators concluded that in patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism, there were no significant between-group differences in the risk for major bleeding, and that intracranial and fatal bleeding occurred less frequently in the rivaroxaban group. This article was selected from Medscape Best Evidence. I'm Dr. Alan Jacobs.
Abstract
This is the Medscape Neurology Minute. I am Dr. Alan Jacobs. Researchers from Duke University's Clinical Research Institute have published a double-blind trial to determine whether rivaroxaban, an oral factor Xa inhibitor, provides more consistent and predictable anticoagulation than warfarin in patients with nonvalvular atrial fibrillation. A total of 14,264 patients were randomly assigned to receive either rivaroxaban 20 mg daily or dose-adjusted warfarin. The primary endpoint was whether rivaroxaban was noninferior to warfarin for the occurrence of stroke or systemic embolism. In the primary analysis, 188 patients in the rivaroxaban group and 241 in the warfarin group reached the primary endpoint. Major and nonmajor clinically relevant bleeding occurred in 14.9%/year in the rivaroxaban group and 14.5%/year in the warfarin group, with a significant reduction in intracranial hemorrhage and fatal bleeding in the rivaroxaban group. The investigators concluded that in patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism, there were no significant between-group differences in the risk for major bleeding, and that intracranial and fatal bleeding occurred less frequently in the rivaroxaban group. This article was selected from Medscape Best Evidence. I'm Dr. Alan Jacobs.
Abstract
Source...