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Rivaroxaban: searching the integral vascular protection
Vivencio Barrios1, Manuel Almendro-Delia2, Lorenzo Facila3
1a Cardiology Department , Hospital Ramón y Cajal , Madrid , Spain.
Expert Review of Clinical Pharmacology
|July 3, 2018
Summary
Rivaroxaban offers vascular protection beyond anticoagulation in patients with cardiovascular disease or atrial fibrillation. Studies show it reduces cardiovascular events, suggesting a broader protective role.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Residual cardiovascular risk persists in patients with atherosclerotic cardiovascular disease (ASCVD) despite current antithrombotic therapies.
- Atrial fibrillation (AF) patients face elevated risks of myocardial infarction and cardiovascular death.
- Novel antithrombotic strategies are needed to mitigate these risks.
Purpose of the Study:
- To review the vascular protective role of rivaroxaban in patients with cardiovascular disease and/or atrial fibrillation.
- To analyze clinical trial data on rivaroxaban's effects beyond its anticoagulant activity.
Main Methods:
- Review of clinical trials, including COMPASS and ROCKET-AF.
- Analysis of experimental data on rivaroxaban's anti-inflammatory, antioxidative, and endothelial function effects.
Main Results:
- In stable ASCVD patients, rivaroxaban (2.5 mg BID) plus aspirin showed superior cardiovascular protection compared to aspirin alone (COMPASS trial).
- In nonvalvular AF patients, rivaroxaban (20 mg QD) was non-inferior to warfarin for stroke prevention, with a trend towards reduced cardiovascular outcomes (ROCKET-AF trial).
- Experimental data suggest rivaroxaban possesses anti-inflammatory and antioxidative properties, potentially improving endothelial dysfunction.
Conclusions:
- Rivaroxaban demonstrates vascular protective effects that extend beyond its anticoagulant properties.
- The findings support rivaroxaban's potential role in managing patients with ASCVD and/or AF.
- Further research may elucidate the full spectrum of rivaroxaban's vascular benefits.
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