Rivaroxaban in the contemporary treatment of acute coronary syndromes.

Article Details

Citation
Copy to clipboard

Alexander D, Jeremias A

Rivaroxaban in the contemporary treatment of acute coronary syndromes.

Expert Opin Investig Drugs. 2011 Jun;20(6):849-57. doi: 10.1517/13543784.2011.580274. Epub 2011 May 10.

PubMed ID
21554163 [ View in PubMed
]
Abstract

INTRODUCTION: Rivaroxaban is the first orally bioavailable direct factor Xa inhibitor and its role in acute coronary syndrome is not fully understood. A significant residual risk of recurrent ischemia remains in patients with acute coronary syndrome despite optimal medical therapy. Warfarin has demonstrated modest benefit that is offset by the risk of bleeding and complexity in its management. Rivaroxaban may be an attractive agent for the treatment of acute coronary syndromes given its predictable pharmacodynamics and favorable safety profile. AREAS COVERED: The current guideline-based antithrombotic and adjunctive medical therapies in acute coronary syndrome are summarized in this review. Rivaroxaban's drug profile, its current applications, ongoing trials and experience in patients with acute coronary syndrome are also described. EXPERT OPINION: Current experience of rivaroxaban in acute coronary syndrome demonstrates its safety and a trend towards benefit when added to current optimal medical therapy. The benefits were observed primarily in patients receiving aspirin monotherapy and increased bleeding among those receiving dual anti-platelet therapy. This suggests that there may be a narrow window between the optimal clinically achievable antithrombotic effect and the point where bleeding risk outweighs the benefits. Though promising, it remains to be seen if this drug will achieve the right balance between efficacy and bleeding risk.

DrugBank Data that Cites this Article

Drugs