THE EFFICIENCY OF RIVAROXABAN WITH OR WITHOUT ASPIRIN AS ANTITHROMBOTIC THERAPY FOR MANAGEMENT OF CARDIOVASCULAR RISK

Mahmudul Hasan*, Mohammad Rashedul Hasan and Monir Uddin Ahamed

ABSTRACT

Background: Cardiovascular diseases is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable Cardiovascular diseases. Objective: In this study our main goal is to evaluate the efficiency of Rivaroxaban with or without aspirin for management of cardiovascular risk. Method: This was a case control study was conducted from January 2020 to January 2021 at tertiary hospital. A random sample of 100 rural and urban individual (age ≥41 years) were included in this study. The eligible participants were informed about the objectives of the study.. Eligible patients with coronary artery disease had to have had a myocardial infarction in the past 10 years, multi-vessel coronary artery disease, history of stable or unstable angina, previous multi-vessel percutaneous coronary intervention, or previous multi-vessel coronary artery bypass graft surgery. After a 30-day run in period, those patients who were receive rivaroxaban (2·5 mg orally twice a day) plus aspirin (75 mg once a day) regarded as a case group, n=50, and those who received aspirin alone (75 mg orally once a day) regarded as acontrol group, n=50. Results: During the study, most of the patients belongs to (41-50) age group, 71%.HTN cases seen in 65%, followed by IHD cases seen in 25%, MI seen in 70% cases, Percutaneous coronary intervention seen in 60%, stroke in 7% cases, heart failure in 25%cases, DM seen in 30% cases and asthma seen in 10% cases. In the study, Stroke, MI and hear failure occurred less frequently in patients in the low-dose rivaroxaban plus aspirin group than in the aspirin alone group. However, in 5% cases major bleeding seen in low-dose rivaroxaban plus aspirin group followed by 3% cases were fatal, 2% were ISTH major bleeding and minor bleeding. Whereas in control group major bleeding cases were quite low, 3%. Followed by 1% cases were fatal, 1% were ISTH major bleeding and minor bleeding. Conclusion: In patients with stable cardiovascular disease, addition of rivaroxaban to aspirin lowered major vascular events, but increased major bleeding. There was no significant increase in intracranial bleeding or other critical organ bleeding. However apart from some downwards addition of rivaroxaban to aspirin has the potential to substantially reduce morbidity and mortality from cardiovascular disease.

Keywords: Cardiovascular diseases (CVD), Rivaroxaban, Antithrombin therapy.