Warfarin vs. Rivaroxaban for Nonvalvular AF
the MPR take:
Rivaroxaban and warfarin have similar efficacy and safety rates in treating nonvalvular atrial fibrillation (AF), although elderly patients do have higher risks compared to younger patients. Published in the journal Circulation, 6,229 patients aged ≥75 years with AF and ≥2 stroke risk factors were randomized to receive warfarin (target international normalized ratio 2.0–3.0) or rivaroxaban (20mg daily; 15mg if creatinine clearance <50mL/min). Older patients were more likely to experience stroke and major bleeding compared to younger patients, but rates were similar among those taking rivaroxaban and warfarin, leading the researchers to support rivaroxaban as an alternative for elderly patients with AF.
Background: Nonvalvular atrial fibrillation (AF) is common in elderly patients, who face an elevated risk of stroke but difficulty sustaining warfarin treatment. Methods and Results-There were 6229 patients (44%) aged 75 years with AF and 2 stroke risk factors randomized to warfarin (target international normalized ratio 2.0-3.0) or rivaroxaban (20mg daily; 15mg if creatinine clearance <50mL/min), double-blind.
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