Vascular protection with rivaroxaban in the comprehensive management of atrial fibrillation.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-12-10 DOI:10.1080/14779072.2023.2276893

Carlos Escobar-Cervantes, Pablo Díez-Villanueva, Clara Bonanad Lozano, Antonio Pose Reino, Manuel Almendro-Delia, Lorenzo Facila, Alfonso Valle, Carmen Suárez

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引用次数: 0

Abstract

Introduction: In addition to an increased risk of thromboembolic complications, patients with atrial fibrillation (AF) are at risk for vascular events. Consequently, complete vascular protection is warranted in these patients.

Areas covered: A narrative search was conducted on PubMed (MEDLINE), using the MeSH terms [Rivaroxaban] + [Atrial fibrillation] + [Cardiovascular] + [Vascular] + [Treatment]. Original data from clinical trials, prospective and retrospective studies, useful reviews and experimental studies, were selected.

Expert opinion: The ROCKET-AF trial showed that rivaroxaban is effective in reducing the risk of stroke, with a lower risk of fatal and intracranial bleeding compared to warfarin. Remarkably, experimental data have provided a number of pathogenic mechanisms through which rivaroxaban could provide beneficial vascular properties beyond its antithrombotic activity. Moreover, in the AF population, additional to its ability to reduce the risk of thromboembolic complications, rivaroxaban is associated with a lower risk of myocardial infarction, major adverse cardiac and limb events, and vascular mortality in patients with diabetes, also attenuating renal impairment during follow-up. These findings suggest that rivaroxaban may provide a comprehensive vascular protection in patients with AF.

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利伐沙班在心房颤动综合治疗中的血管保护作用。

引言：除了血栓栓塞并发症的风险增加外，心房颤动（AF）患者还有发生血管事件的风险。因此，这些患者需要完全的血管保护。涵盖领域：在PubMed（MEDLINE）上使用MeSH术语[Rivaroxaban]进行叙述性搜索 + [心房颤动] + [心血管] + [血管] + [治疗]。从临床试验、前瞻性和回顾性研究、有用的综述和实验研究中选择原始数据。专家意见：ROCKET-AF试验表明，利伐沙班在降低中风风险方面有效，与华法林相比，致命性和颅内出血的风险更低。值得注意的是，实验数据提供了许多致病机制，通过这些机制，利伐沙班可以在抗血栓活性之外提供有益的血管特性。此外，在房颤人群中，利伐沙班除了能够降低血栓栓塞并发症的风险外，还可以降低糖尿病患者心肌梗死、重大心脏和肢体不良事件以及血管死亡率的风险，并在随访期间减轻肾损伤。这些发现表明利伐沙班可能为AF患者提供全面的血管保护。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.70

自引率

0.00%

发文量

期刊介绍： Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.