Efficacy and safety of rivaroxaban in anticoagulant therapy in elderly patients with nonvalvular atrial fibrillation

Wu Yutao; Yao Lu; Tian Guoxiang; Liu Lixin; Chen Yanmei; Xia Changquan; Zhang Wei; Gao Yingchun

doi:10.3969/j.issn.1674-4055.2017.09.12

Abstract：Objective To study the efficacy and safety of long-term use of rivaroxaban in the treatment of elderly patients with nonvalvular atrial fibrillation (NVAF). Methods The NVAF patients were divided into two groups, including oldest-old group (n=38, ≥80 years old, average age=85.20±3.05) and old group (n=37, 65-79 years old, average age=76.5±2.07). The initial oral dose of rivaroxaban was determined according to the HAS-BLED score, and the dose was adjusted according to condition of patients. Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (D-D), platelet count (PLT) were measured before and during the treatment. The clinical embolism events and adverse drug reactions (bleeding, rash, fecal occult blood positive, etc.) during one-year follow-up were compared between two groups. Results The average dose of rivaroxaban in oldest-old group and old group was (10.00±2.50) mg/d and (10.13±2.63) mg/d respectively (range from 5 to 15 mg/d), the difference was not statistically significant (P>0.05). After treatment for 1 month, 6 months and 12 months, the levels of PT, APTT and TT were increased, the levels of FIB and D-D were deceased in oldest-old group, the differences were statistically significant (all P<0.05). After treatment for 1 month, 6 months and 12 months, the levels of PT, APTT and TT were increased, the levels of FIB and D-D were deceased in old group, the differences were statistically significant (all P<0.05). No recurrence of acute cerebral infarction, no severe bleeding was recorded. Mild bleeding was disappeared after adjusting dose. Conclutions Rivaroxaban (5-15 mg / d) is effective and safe for elderly NVAF patients.