Marcelo Sanmartín Fernández1, Francisco Marín2, Carles Rafols3, Fernando Arribas4, Vivencio Barrios5, Juan Cosín-Sales6, Manuel Anguita Sánchez7. 1. Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain. 2. Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain. 3. Department of Medical Affairs, Bayer Hispania, Barcelona, Spain. 4. Department of Cardiology, Hospital Universitario 12 de Octubre; Department of Medicine, Facultad de Medicina, Universidad Complutense de Madrid (UCM); Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); CIBERCV, Madrid, Spain. 5. Department of Cardiology, Hospital Ramón y Cajal; Alcalá University, Madrid, Spain. 6. Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain. 7. Department of Cardiology, Hospital Universitario Reina Sofia, IMIBIC, University of Córdoba, Córdoba, Spain.
Abstract
Aim: To analyze the frequency and variables related to inappropriate rivaroxaban dosage in clinical practice and its impact on outcomes after 2 years. Materials & methods: Postauthorization, observational, multicenter study, in which atrial fibrillation patients, treated with rivaroxaban ≥6 months were included. Results: A total of 1421 patients (74.2 ± 9.7 years, CHA2DS2-VASc 3.5 ± 1.6) were included. Overall, 22.9% received rivaroxaban 15 mg. The proper dose of rivaroxaban was taken by 83.3% (9.7% underdosed, 7.0% overdosed). Older age and renal insufficiency were associated with inadequate rivaroxaban dosage. There was a trend toward higher all-cause mortality among underdosed patients (adjusted hazard ratio 1.39; 95% CI 0.75-2.58), and more bleedings in overdosed patients (2.29 vs 0.80 events/100 patient-years; p = 0.14). Conclusion: In clinical practice, rivaroxaban is properly dosed in most patients.
Aim: To analyze the frequency and variables related to inappropriate rivaroxaban dosage in clinical practice and its impact on outcomes after 2 years. Materials & methods: Postauthorization, observational, multicenter study, in which atrial fibrillation patients, treated with rivaroxaban ≥6 months were included. Results: A total of 1421 patients (74.2 ± 9.7 years, CHA2DS2-VASc 3.5 ± 1.6) were included. Overall, 22.9% received rivaroxaban 15 mg. The proper dose of rivaroxaban was taken by 83.3% (9.7% underdosed, 7.0% overdosed). Older age and renal insufficiency were associated with inadequate rivaroxaban dosage. There was a trend toward higher all-cause mortality among underdosed patients (adjusted hazard ratio 1.39; 95% CI 0.75-2.58), and more bleedings in overdosed patients (2.29 vs 0.80 events/100 patient-years; p = 0.14). Conclusion: In clinical practice, rivaroxaban is properly dosed in most patients.
Entities:
Keywords:
atrial fibrillation; dosage; major bleeding; overdosage; rivaroxaban; stroke; underdosage
Authors: Marcelo Sanmartín Fernández; Manuel Anguita Sánchez; Fernando Arribas; Gonzalo Barón-Esquivias; Vivencio Barrios; Juan Cosin-Sales; María Asunción Esteve-Pastor; Roman Freixa-Pamias; Iñaki Lekuona; Alejandro I Pérez-Cabeza; Isabel Ureña; José Manuel Vázquez Rodríguez; Carles Rafols Priu; Francisco Marin Journal: Cardiol J Date: 2022-05-27 Impact factor: 3.487