Related Experiment Video
Updated: Aug 18, 2025
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
5.2K
Rivaroxaban in Patients With Atrial Fibrillation Who Underwent Percutaneous Coronary Intervention in Clinical
Uwe Zeymer1, Ralph Toelg2, Harm Wienbergen3
1Klinikum Ludwigshafen, Ludwigshafen, Germany; Institut für Herzinfarktforschung Ludwigshafen, Germany.
The American Journal of Cardiology
|December 9, 2022
Summary
This study found rivaroxaban in atrial fibrillation (AF) patients post-percutaneous coronary intervention (PCI) showed comparable ischemic and bleeding event rates to a previous trial. Real-world data supports its use in this complex patient group.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Efficacy and safety of rivaroxaban in atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) in real-world practice are not well-established.
- Limited clinical data exists for rivaroxaban use in this specific high-risk patient population.
Purpose of the Study:
- To evaluate the rate of ischemic, embolic, and bleeding events in AF patients treated with rivaroxaban after PCI in a real-world setting.
- To compare these event rates with findings from the PIONEER-AF PCI trial.
Main Methods:
- Prospective, noninterventional, multicenter observational study (RIVA-PCI).
- Enrolled 700 patients with AF who underwent PCI and were discharged on rivaroxaban.
- Follow-up conducted for up to 14 months, collecting data on clinical events.
Main Results:
- Ischemic event rates: cardiovascular death (2.0%), myocardial infarction (0.9%), stent thrombosis (0.2%), stroke (1.3%).
- Bleeding event rates: ISTH major bleeding (4.2%), ISTH nonmajor clinically relevant bleeding (15.3%).
- Event rates were comparable to those reported in the PIONEER-AF PCI trial.
Conclusions:
- Rivaroxaban use in AF patients following PCI is associated with comparable ischemic and bleeding event rates to those seen in the PIONEER-AF PCI trial.
- This real-world data supports the use of rivaroxaban in this patient population.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.3K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K
01:29Venous Thrombosis III: Interprofessional Care
16
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
16
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
827
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
827
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
24
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
24
01:26Cardiac Catheterization IV: Nursing Management
113
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
113
01:28Acute Coronary Syndrome IV: Interprofessional Care
21
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
21