Application of 10 mg/d and 15 mg/d Rivaroxaban in Nonvalvular Atrial Fibrillation Patients Aged 75 Years and above
Objective To analyse the effectiveness and safety of rivaroxaban at dosage of 10 mg/d and 15 mg/d in elderly patients with nonvalvular atrial fibrillation(NVAF),and investigate the factors that may contribute to the incidence of both efficacy and safety-related events.Methods A total of 259 NVAF patients aged 75 years and older who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to December 2021 were selected.According to the dose of rivaroxaban at the time of discharge,the patients were divided into two groups:the 10 mg group(n=167)and the 15 mg group(n=92).The patients were followed up for 1 year,and death,ischemic stroke and bleeding events were recorded.Factors influencing the rivaroxaban dosage selection and the occurrence of outcome events were analyzed.Results Mortality,the rate of ischemic stroke events,and bleeding events in the 2 groups were compared,and the difference was not statistically significant(all P＞0.05).Regression analysis found that 10 mg/d rivaroxaban was more recommended with increasing age(OR=0.866,95％CI:0.807-0.929,P＜0.001).Additionally,patients with heart failure(OR=3.783,95％CI:1.355-10.561,P＜0.05),myocardial infarction(OR=5.287,95％CI:1.692-16.525,P＜0.01)were more likely to experience death or ischemic stroke events.Patients with neoplasms(OR=6.389,95％CI:1.772-23.029,P＜0.01)were more likely to have bleeding events.Conclusion 10 mg/d has the same safety and efficacy as 15 mg/d rivaroxaban.Preventive management of NVAF patients associated with heart failure,myocardial infarction,and neoplasms should be strengthened to prevent adverse events.
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