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Low-Dose Rivaroxaban in Patients with Atrial Fibrillation and Coronary Heart Disease: Anticoagulation Effect 1 Year After Percutaneous Coronary Intervention and Its Influence on the Incidence of Stroke and Cardiovascular Events
Authors:  Tao Ding, B.S., Li-juan Li, B.S., Ming-qiang Fan, M.D., Jing Bai, B.S., Xiang-xiang Yang, B.S., Yu Cao, B.S., Xia Su, B.S., and Hui Dai, B.S.
  Objective: To explore the effect of low-dose rivaroxaban on anticoagulation and incidence of cardiovascular events in patients with atrial fibrillation and coronary heart disease (CHD) following percutaneous coronary intervention (PCI).
Study Design:
A total of 150 inpatients diagnosed with atrial fibrillation combined with CHD and who underwent PCI were recruited in this study. The patients were ranked in accordance with hospitalization order, with odd numbers as the control group and even numbers as the observation group (n=75 per group). Patients in both groups were treated with aspirin and clopidogrel. On this basis, the patients in the control group were given warfarin, while those in the observation group were given oral rivaroxaban. The coagulation indexes, blood lipid indexes, and occurrence of cardiovascular events and bleeding events were compared between groups.
Compared with the control group, activated partial thromboplastin time (45.88±4.54 vs. 40.62±4.30 seconds) and plasma thrombin time (34.01±6.66 vs. 29.33±5.03 seconds) were significantly longer in the observation group after treatment (p<0.05). After treatment, the differences were not significant in the levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol between the 2 groups (p>0.05). The total incidence of cardiovascular adverse events was lower in the observation group than that in the control group (4.00% vs. 14.67%, p<0.05). There was no significant difference in total incidence of bleeding events and incidence of adverse reactions between the 2 groups (p>0.05).
The anticoagulation effect of low-dose rivaroxaban combined with aspirin and clopidogrel is better than that of warfarin combined with aspirin in patients with atrial fibrillation and CHD at 1 year after PCI, which can effectively diminish the incidence of cardiovascular adverse events. There was no marked increase in bleeding risk, and the safety was high.
Keywords:  atrial fibrillation, cardiovascular event, coronary heart disease, percutaneous coronary intervention, rivaroxaban
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