Rivaroxaban in Patients with a Recent Acute Coronary Syndrome

In patients with acute coronary syndromes, low doses of rivaroxaban were effective in reducing the primary end point of death from cardiovascular causes, myocardial infarction, or stroke. Rivaroxaban also reduced overall mortality, although there was more bleeding. After an acute coronary syndrome,...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 366; no. 1; pp. 9 - 19
Main Authors: Mega, Jessica L, Braunwald, Eugene, Wiviott, Stephen D, Bassand, Jean-Pierre, Bhatt, Deepak L, Bode, Christoph, Burton, Paul, Cohen, Marc, Cook-Bruns, Nancy, Fox, Keith A.A, Goto, Shinya, Murphy, Sabina A, Plotnikov, Alexei N, Schneider, David, Sun, Xiang, Verheugt, Freek W.A, Gibson, C. Michael
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 05.01.2012
Subjects:
Acute Coronary Syndrome - drug therapy
Acute coronary syndromes
Aged
Angina pectoris
Anticoagulants
Anticoagulants - administration & dosage
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Arteriosclerosis
Biological and medical sciences
Bleeding
Cardiology. Vascular system
Cardiovascular disease
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Cardiovascular Diseases - prevention & control
Cerebral infarction
Coronary artery
Coronary heart disease
Death
Double-Blind Method
Drug Administration Schedule
Factor Xa Inhibitors
Female
General aspects
Heart
Heart attacks
Heart surgery
Hemorrhage
Hemorrhage - chemically induced
Hemorrhage - mortality
Humans
Incidence
Intracranial Hemorrhages - chemically induced
Kaplan-Meier Estimate
Male
Medical sciences
Middle Aged
Morpholines - administration & dosage
Morpholines - adverse effects
Morpholines - therapeutic use
Myocardial infarction
Myocarditis. Cardiomyopathies
Rivaroxaban
Secondary Prevention
Thiophenes - administration & dosage
Thiophenes - adverse effects
Thiophenes - therapeutic use
Thrombosis
Human
Medicine
Rivaroxaban
Antithrombotic agent
Cardiovascular disease
Patient
Acute coronary syndrome
Coronary heart disease
Myocardial disease
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In patients with acute coronary syndromes, low doses of rivaroxaban were effective in reducing the primary end point of death from cardiovascular causes, myocardial infarction, or stroke. Rivaroxaban also reduced overall mortality, although there was more bleeding. After an acute coronary syndrome, patients remain at risk for recurrent cardiovascular events despite standard medical therapy, including long-term antiplatelet therapy with aspirin and an adenosine diphosphate–receptor inhibitor. This risk may be related in part to excess thrombin generation that persists beyond the acute presentation in such patients. 1 As a result, there has been interest in evaluating the role of oral anticoagulants after an acute coronary syndrome. Improved cardiovascular outcomes were reported for patients who were treated with the anticoagulant warfarin in addition to aspirin. 2 However, widespread use of long-term warfarin in such patients has been limited by challenges associated . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1112277