Rivaroxaban is used as the first-line treatment for atrial fibrillation (AF). However, its effects in patients with AF and bioprosthetic mitral valve (BMV) remain uncertain. This study aims to evaluate the safety and efficacy of rivaroxaban in patients with AF and BMV.
This randomized trial included a total of 1,005 patients with AF and a BMV. The patients were assigned in a 2:3 ratio to receive rivaroxaban (20 mg once daily) or dose-adjusted warfarin. The primary outcome of the study was a composite of mortality, major cardiovascular events (myocardial infarction, ischemic attack, or heart failure), or major bleeding.
A primary event was reported at a mean of 347.5 days in the rivaroxaban group and 340.1 days in the warfarin group. Death due to cardiovascular or thromboembolic events occurred in 17 patients (3.4%) in the rivaroxaban group and in 26 (5.1%) patients in the warfarin group. The incidence of stroke was 0.6% in the rivaroxaban group and 2.4% in the warfarin group. The incidence of major bleeding events was 1.4% in the rivaroxaban group and 2.6% in the warfarin group.
The research concluded that treatment with rivaroxaban was non-inferior to warfarin in patients with atrial fibrillation and bioprosthetic mitral valve.
Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2029603
