Efficacy of different doses of rivaroxaban combined with rosuvastatin in patients with atrial fibrillation complicated with coronary heart disease

Ma Le; Shi Rui; He Jianrong; Xie Dashuai; Yuan Wenlong; Shi Ping

doi:10.3969/j.issn.1672-8157.2025.05.038

Abstract：Objective To investigate the clinical efficacy of different doses of rivaroxaban combined with rosuvastatin in pa-tients with atrial fibrillation complicated with coronary heart disease.Methods A total of 200 patients with atrial fibrillation com-plicated with coronary heart disease admitted to Yuncheng Central Hospital Affiliated to Shanxi Medical University from November 2021 to October 2023 were selected.The patients were divided into three groups according to the dose of rivaroxaban:group A(49 cases,conventional basic treatment+rivaroxaban 10 mg+rosuvastatin 10 mg),group B(83 cases,conventional basic treatment+rivaroxaban 15 mg+rosuvastatin 10 mg),and group C(68 cases,conventional basic treatment+rivaroxaban 20 mg+rosuvasta-tin 10 mg).The clinical efficacy,coagulation function indicators(activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fg)),vascular endothelial function indicators(von willebrand factor(vWF),angiotensin Ⅱ(Ang Ⅱ),endothelin(ET-1),vascular endothelial growth factor(VEGF))before treatment and 3 months after treatment,the occur-rence of hemorrhage and ischemic events as well as adverse reactions during the treatment period were compared among the three groups.Results The total effective rate was 87.76％(43/49)in group A,91.57％(76/83)in group B,and 82.35％(56/68)in group C,with no statistically significant difference among the three groups(χ2=2.905,P>0.05).After 3 months of treatment,the levels of APTT,PT,and TT increased,and the Fg level decreased in all three groups,but there were no statistically significant differences in the levels of APTT,PT,TT and Fg among the three groups(F=1.394,0.925,1.589,1.089,all P>0.05).After 3 months of treatment,the levels of vWF,Ang Ⅱ,and ET-1 decreased,and the VEGF level increased in the three groups,but there were no statistically sig-nificant differences in the levels of vWF,Ang Ⅱ,ET-1 and VEGF among the three groups(F=0.759,1.118,2.213,0.943,all P>0.05).The incidence of hemorrhage and ischemic events in group C were 10.29％(7/68)and 10.29％(7/68),which were higher than those in group A(2.04％(1/49)and 4.08％(2/49)),and in group B(3.61％(3/83)and 4.82％(4/83)),but there were no statistically signifi-cant differences among the three groups(χ2=4.703,2.468,both P>0.05).The incidence of adverse reactions in group C was 14.71％(10/68),which was higher than that in group A(6.12％(3/49))and in group B(8.43％(7/83)),but there was no statistically significant difference among the three groups(χ2=2.718,P>0.05).Conclusion Different doses of rivaroxaban combined with rosuvastatin demonstrate good efficacy for treating patients with atrial fibrillation complicated with coronary heart disease,significantly improv-ing coagulation function and vascular endothelial function.However,the incidence of adverse events and reactions at a dose of 20 mg of rivaroxaban is relatively high.Therefore,the use of 10 mg and 15 mg doses of rivaroxaban is recommended for treatment.