Shanshan Xie1, Jingjing Chen2, Gang Xiong3, Juan Li1,4, Jinjin Wan1, Ye Liu1, Ruilai Xu5, Weifang Zhang6,7. 1. Department of Pharmacy, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China. 2. Department of Pharmacy, Guangqian Hospital of Quanzhou, Quanzhou, 362321, China. 3. Department of Information, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China. 4. Department of Pharmacology, School of Pharmaceutical Science, Nanchang University, Nanchang, 330006, Jiangxi, China. 5. Department of Pharmacy, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China. xruilai@163.com. 6. Department of Pharmacy, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China. z_weifang@163.com. 7. Department of Pharmacology, School of Pharmaceutical Science, Nanchang University, Nanchang, 330006, Jiangxi, China. z_weifang@163.com.
Abstract
PURPOSE: To explore the efficacy and safety of rivaroxaban in patients with coronary artery disease (CAD), heart failure (HF) and sinus rhythm (SR). METHODS: Comprehensive literature searches were conducted using the PubMed, Cochrane Library, Embase, CNKI and Wanfang databases from inception to February 2021. Randomized controlled trials (RCTs) focusing on the efficacy and safety of new oral anticoagulant (NOAC) therapy in CAD and HF patients in SR were eligible. Statistical analyses were performed using R Programming Language. RESULTS: Three RCTs included 10,658 adult patients treated with antiplatelet drugs with or without rivaroxaban were ultimately analysed. The average follow-up period was 20.4-24 months. Rivaroxaban had a favourable point estimate in myocardial infarction (MI) and stroke (MI rivaroxaban group (3.83%, 203/5306) vs. APT group (4.52%, 214/4731), RR = 0.78, 95% CI 0.65-0.94, P < 0.01, I2 = 0%), (stroke: rivaroxaban group (1.60%, 85/5306) vs. APT group (2.52%, 119/4731), RR = 0.64, 95% CI 0.49-0.85, P < 0.01, I2 = 12%) compared with the placebo. Rivaroxaban was comparable to the placebo for all-cause death and major bleeding (all-cause death: rivaroxaban group (12.27%, 688/5606) vs. APT group (14.59%, 737/5052), RR = 0.73, 95% CI 0.49-1.06, P > 0.05, I2 = 87%), (major bleeding: rivaroxaban group (1.52%, 85/5586) vs. APT group (1.37%, 69/5043), RR = 1.18, 95% CI 0.86-1.62, P > 0.05, I2 = 0%). CONCLUSIONS: In SR patients with CAD and HF, the rates of MI and stroke associated with rivaroxaban combined with APT were lower than those associated with APT alone, and the two treatments had similar rates of all-cause death and major bleeding.
PURPOSE: To explore the efficacy and safety of rivaroxaban in patients with coronary artery disease (CAD), heart failure (HF) and sinus rhythm (SR). METHODS: Comprehensive literature searches were conducted using the PubMed, Cochrane Library, Embase, CNKI and Wanfang databases from inception to February 2021. Randomized controlled trials (RCTs) focusing on the efficacy and safety of new oral anticoagulant (NOAC) therapy in CAD and HF patients in SR were eligible. Statistical analyses were performed using R Programming Language. RESULTS: Three RCTs included 10,658 adult patients treated with antiplatelet drugs with or without rivaroxaban were ultimately analysed. The average follow-up period was 20.4-24 months. Rivaroxaban had a favourable point estimate in myocardial infarction (MI) and stroke (MI rivaroxaban group (3.83%, 203/5306) vs. APT group (4.52%, 214/4731), RR = 0.78, 95% CI 0.65-0.94, P < 0.01, I2 = 0%), (stroke: rivaroxaban group (1.60%, 85/5306) vs. APT group (2.52%, 119/4731), RR = 0.64, 95% CI 0.49-0.85, P < 0.01, I2 = 12%) compared with the placebo. Rivaroxaban was comparable to the placebo for all-cause death and major bleeding (all-cause death: rivaroxaban group (12.27%, 688/5606) vs. APT group (14.59%, 737/5052), RR = 0.73, 95% CI 0.49-1.06, P > 0.05, I2 = 87%), (major bleeding: rivaroxaban group (1.52%, 85/5586) vs. APT group (1.37%, 69/5043), RR = 1.18, 95% CI 0.86-1.62, P > 0.05, I2 = 0%). CONCLUSIONS: In SR patients with CAD and HF, the rates of MI and stroke associated with rivaroxaban combined with APT were lower than those associated with APT alone, and the two treatments had similar rates of all-cause death and major bleeding.
Authors: John W Eikelboom; Stuart J Connolly; Jackie Bosch; Gilles R Dagenais; Robert G Hart; Olga Shestakovska; Rafael Diaz; Marco Alings; Eva M Lonn; Sonia S Anand; Petr Widimsky; Masatsugu Hori; Alvaro Avezum; Leopoldo S Piegas; Kelley R H Branch; Jeffrey Probstfield; Deepak L Bhatt; Jun Zhu; Yan Liang; Aldo P Maggioni; Patricio Lopez-Jaramillo; Martin O'Donnell; Ajay K Kakkar; Keith A A Fox; Alexander N Parkhomenko; Georg Ertl; Stefan Störk; Matyas Keltai; Lars Ryden; Nana Pogosova; Antonio L Dans; Fernando Lanas; Patrick J Commerford; Christian Torp-Pedersen; Tomek J Guzik; Peter B Verhamme; Dragos Vinereanu; Jae-Hyung Kim; Andrew M Tonkin; Basil S Lewis; Camilo Felix; Khalid Yusoff; P Gabriel Steg; Kaj P Metsarinne; Nancy Cook Bruns; Frank Misselwitz; Edmond Chen; Darryl Leong; Salim Yusuf Journal: N Engl J Med Date: 2017-08-27 Impact factor: 91.245
Authors: Robert C Welsh; Matthew T Roe; Philippe Gabriel Steg; Stefan James; Thomas J Povsic; Christoph Bode; Charles Michael Gibson; Erik Magnus Ohman Journal: Am Heart J Date: 2016-08-30 Impact factor: 4.749
Authors: Christian T Ruff; Robert P Giugliano; Eugene Braunwald; Elaine B Hoffman; Naveen Deenadayalu; Michael D Ezekowitz; A John Camm; Jeffrey I Weitz; Basil S Lewis; Alexander Parkhomenko; Takeshi Yamashita; Elliott M Antman Journal: Lancet Date: 2013-12-04 Impact factor: 79.321
Authors: Faiez Zannad; Stefan D Anker; William M Byra; John G F Cleland; Min Fu; Mihai Gheorghiade; Carolyn S P Lam; Mandeep R Mehra; James D Neaton; Christopher C Nessel; Theodore E Spiro; Dirk J van Veldhuisen; Barry Greenberg Journal: N Engl J Med Date: 2018-08-27 Impact factor: 91.245
Authors: Kelley R Branch; Jeffrey L Probstfield; John W Eikelboom; Jackie Bosch; Aldo P Maggioni; Richard K Cheng; Deepak L Bhatt; Alvaro Avezum; Keith A A Fox; Stuart J Connolly; Olga Shestakovska; Salim Yusuf Journal: Circulation Date: 2019-06-05 Impact factor: 29.690