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Rivaroxaban as good as warfarin in AF patients with bioprosthetic mitral valves: RIVER trial
Researchers have found in The RIVER trial, the largest study that anticoagulant rivaroxaban worked as well as the standard anticoagulant medication warfarin in patients with an artificial mitral valve to correct Atrial fibrillation.
It was one of the largest study to assess the efficacy and safety of the anticoagulant rivaroxaban.
The interesting and breakthrough findings have been put forth in American Heart Association's Scientific Sessions conducted from November 13 to November 17 ,2020.
"This is the largest trial designed to evaluate the safety and efficacy of direct oral anticoagulants in patients with bioprosthetic mitral valves and atrial fibrillation or flutter. Earlier trials of direct oral anticoagulants vs. warfarin for atrial fibrillation or flutter together included fewer than 200 patients with bioprosthetic mitral valves," said lead study author Otavio Berwanger, a cardiologist and epidemiologist, and the director of the Research Institute Hcor, Heart Hospital .
The RIVER trial followed 1,005 patients from 49 sites in Brazil who had a bioprosthetic mitral valve and atrial fibrillation or flutter for 12 months. Patients were randomized to rivaroxaban 20 mg once daily or the vitamin K antagonist anticoagulant warfarin (dose-adjusted to an international normalized ratio (INR) between 2.0-3.0). The primary endpoint was a composite of death, major cardiovascular events (stroke, transient ischemic attack, systemic embolism, valve thrombosis or hospitalization for heart failure) or major bleeding over 12 months.
A major finding highlighted that Patients who received rivaroxaban had an average of almost one year (347.5 days) free from the primary endpoint, similar to those treated with warfarin (340.1 days).
On further subgroup analysis of 18.8% of RIVER patients with bioprosthetic mitral valve implantation within the prior three months showed a mean of 35.1 days longer without evidence of the primary outcome compared to patients treated with warfarin.
"Additionally, our confidence interval likely excluded an effect size larger than 1.4 days free from events favoring warfarin, clearly demonstrating the non-inferiority effect of rivaroxaban in this clinical setting," the team quoted.
For full article follow the link: https://newsroom.heart.org/news/rivaroxaban-may-be-as-effective-as-warfarin-for-bioprosthetic-mitral-valves-af?preview=809957187cbbd683538afd4ab019a7a1
Dr Satabdi Saha (BDS, MDS) is a practicing pediatric dentist with a keen interest in new medical researches and updates. She has completed her BDS from North Bengal Dental College ,Darjeeling. Then she went on to secure an ALL INDIA NEET PG rank and completed her MDS from the first dental college in the country – Dr R. Ahmed Dental College and Hospital. She is currently attached to The Marwari Relief Society Hospital as a consultant along with private practice of 2 years. She has published scientific papers in national and international journals. Her strong passion of sharing knowledge with the medical fraternity has motivated her to be a part of Medical Dialogues.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751