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Long-lasting Rivaroxaban Use Is Associated With Lower Aortic Valve Leaflet Calcification in Severe Aortic Stenosis
Magdalena Kopytek1, Jacek Tarasiuk2, Sebastian Wroński2
1Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; Krakow Centre for Medical Research and Technologies, St. John Paul II Hospital, Krakow, Poland.
The Canadian Journal of Cardiology
|June 29, 2025
Summary
Direct oral anticoagulants like rivaroxaban may reduce aortic stenosis calcification. This study found lower valvular calcification and related protein expression in patients treated with rivaroxaban.
Area of Science:
- Cardiology
- Pharmacology
- Biomedical Engineering
Background:
- In vitro studies suggest direct oral anticoagulants (DOACs) inhibit calcification and inflammation.
- This study investigates the association between DOAC therapy and reduced valvular calcification in patients with aortic stenosis (AS) and atrial fibrillation (AF).
Purpose of the Study:
- To evaluate if DOAC therapy is associated with decreased valvular calcification in patients with AS who are anticoagulated for AF.
Main Methods:
- A case-control study compared 72 patients with severe AS to 53 patients with AF and severe AS treated with DOACs.
- Microcomputed tomography (micro-CT) assessed calcification in aortic valves from patients on rivaroxaban versus non-anticoagulated AS patients.
- Valvular expression of osteopontin, NF-κB, and IL-6 was evaluated using immunostaining.
Main Results:
- Rivaroxaban users showed significantly lower calcium volume, surface volume, CV/SV ratio, and maximal trabecular thickness via micro-CT.
- Osteopontin and NF-κB expression were reduced, and IL-6 intensity was lower in rivaroxaban-treated patients.
- Rivaroxaban use duration correlated inversely with micro-CT parameters and positively with osteopontin expression.
Conclusions:
- Long-term rivaroxaban use in AS patients is linked to reduced aortic valve leaflet calcification.
- The findings suggest a potential role for rivaroxaban in mitigating valvular calcification progression.
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