More cardiovascular events and deaths occurred among rivaroxaban users than in VKA users during a 3-year follow-up.
Factor Xa inhibitors are commonly used to reduce stroke risk in patients with atrial fibrillation. However, because clinical trials of these medications excluded people with rheumatic heart disease, guidelines do not recommend these oral anticoagulants for atrial fibrillation in those patients. In the industry-funded INVICTUS trial (NCT02832544), investigators assessed the efficacy and safety of the factor Xa inhibitor rivaroxaban, as compared with vitamin K antagonists (VKAs), in patients with rheumatic heart disease–associated atrial fibrillation. Rivaroxaban is not approved for this indication in these patients.
The randomized, noninferiority trial enrolled 4565 patients from 138 sites in 24 countries in Africa, Asia, and South America. T…
Reviewing Author
DisclosuresConsultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime
EquityHugo Health; Refactor Health; Element Science
Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association
DisclosuresConsultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime
EquityHugo Health; Refactor Health; Element Science
Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association