Mao Lizheng, Li Chengyan, Li Tao, Yuan Kunxiong
Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
Vascular. 2014 Aug;22(4):252-8. doi: 10.1177/1708538113490423. Epub 2013 Jun 18.
This study assessed the effects and safety of rivaroxaban versus warfarin in Chinese patients with atrial fibrillation. In this double-blind clinical trial, a total of 353 consecutive patients with atrial fibrillation who were at risk of stroke or systemic embolism were enrolled to receive either rivaroxaban or warfarin. The primary effect endpoint occurred in five patients in the rivaroxaban group (2.29% per year) and in seven patients in the warfarin group (2.91% per year) (hazard ratio with warfarin, 0.76, 95% CI, 0.64-0.91; p = 0.03). Major and non-major clinically relevant bleeding occurred in 38 patients (14.3% per year) in the rivaroxaban group and in 36 patients (13.7% per year) in the warfarin group (hazard ratio rivaroxaban versus warfarin, 1.07; 95% CI, 0.93-1.14; p = 0.39). Adverse events were similar between these two arms (p > 0.05). In conclusion, oral administration of rivaroxaban reduced the risk of stroke or systemic embolism without significantly increasing the safety concern.
本研究评估了利伐沙班与华法林对中国房颤患者的疗效及安全性。在这项双盲临床试验中,共纳入353例有卒中或全身性栓塞风险的连续性房颤患者,接受利伐沙班或华法林治疗。利伐沙班组有5例患者出现主要疗效终点事件(每年2.29%),华法林组有7例患者出现该事件(每年2.91%)(华法林的风险比为0.76,95%置信区间为0.64 - 0.91;p = 0.03)。利伐沙班组有38例患者发生主要和非主要的临床相关出血事件(每年14.3%),华法林组有36例患者发生该事件(每年13.7%)(利伐沙班与华法林的风险比为1.07;95%置信区间为0.93 - 1.14;p = 0.39)。两组的不良事件相似(p > 0.05)。总之,口服利伐沙班可降低卒中或全身性栓塞风险,且未显著增加安全性担忧。