دورية أكاديمية
What is Standard Dose of Rivaroxaban in Elderly Asian Patients with Atrial Fibrillation: 20ms versus. 15mg?
| العنوان: | What is Standard Dose of Rivaroxaban in Elderly Asian Patients with Atrial Fibrillation: 20ms versus. 15mg? |
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| المؤلفون: | Sung Soo Kim MD, Ki Hong Lee MD, PhD, Nam Sik Yoon MD, PhD, Hyung Wook Park MD, PhD, Jeong Gwan Cho MD, PhD |
| المصدر: | Clinical and Applied Thrombosis/Hemostasis, Vol 27 (2021) |
| بيانات النشر: | SAGE Publishing, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system |
| مصطلحات موضوعية: | Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| الوصف: | Although there is no age criterion for rivaroxaban dose reduction, elderly patients with atrial fibrillation (AF) are often prescribed an off-label reduced dose. We aimed to evaluate whether age is a necessary criterion for rivaroxaban dose reduction in Korean patients with AF. Among 2208 patients who prescribed warfarin or rivaroxaban, 552 patients over 75 years without renal dysfunction (creatinine clearance >50 mL/min) were compared based on propensity score matching. The rivaroxaban group was further divided into a 20 mg (R20; on-label) and a 15 mg (R15; off-label). Primary net clinical benefit (NCB) was defined as the composite of stroke, systemic embolism, major bleeding, and all-cause mortality. Secondary NCB was defined as the composite of stroke, systemic embolism, and major bleeding. Patients were followed for 1 year, or until the first outcome occurrence. Both rivaroxaban groups had comparable efficacy compared with warfarin. However, both R20 (0.9% vs 7.4%, p = .014) and R15 (2.3% vs 7.4%, p = .018) had a significant reduction in major bleeding. There were no differences in efficacy or safety outcomes between R20 and R15. R20 had significantly reduced primary (hazard ratio [HR] 0.33, 95% confidence interval [CI]: 0.12–0.93) and secondary (HR 0.31, 95% CI: 0.10–0.93) NCBs compared with warfarin. However, primary and secondary NCBs were not reduced in R15. In real-world practice with elderly patients with AF, off-label rivaroxaban dose reduction to 15 mg conferred no benefits. Therefore, guideline-adherent rivaroxaban 20 mg is favorable in elderly Korean patients with AF. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1938-2723 10760296 |
| العلاقة: | https://doaj.org/toc/1938-2723Test |
| DOI: | 10.1177/10760296211061148 |
| الوصول الحر: | https://doaj.org/article/dea0958fe5bd483d8a183ef283e54f5fTest |
| رقم الانضمام: | edsdoj.0958fe5bd483d8a183ef283e54f5f |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 19382723 10760296 |
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| DOI: | 10.1177/10760296211061148 |