EVALUATING THE RISK-BENEFIT PROFILE OF RIVAROXABAN VERSUS WARFARIN IN STROKE PREVENTION AMONG ELDERLY PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION; A RETROSPECTIVE COHORT STUDY
Main Article Content
Keywords
Ischemic stroke, Rivaroxaban, Warfarin, Non-valvular atrial fibrillation
Abstract
Background and Aim: Non-valvular atrial fibrillation (NVAF) is particularly common in the elderly, with more than 50% of NVAF patients over 80 years of age. The present study aimed to assess the risk-benefit profile of Rivaroxaban versus Warfarin in stroke prevention among patients with non-valvular atrial fibrillation.
Patients and Methods: This retrospective cohort study evaluated 100 NVAF patients treated with Warfarin or Rivaroxaban in the Department of Pharmacology in collaboration with Cardiology Unit of Tertiary Care Hospital, Lahore from April 2022 to April 2024. All the patients were categorized into two groups; Group-I (Rivaroxaban treated patients, N=50) and Group-II (Warfarin treated patients, N=50). The prescription of rivaroxaban, appropriate dosing, non-gastrointestinal bleeding (NGIB), ischemic stroke, and gastrointestinal bleeding (GIB) were different outcomes measured during investigation. Data analysis was done using SPSS version 27.
Results: The overall mean age was 66.4±11.4 years with an age range 16-80 years. Of the total 100 NVAF patients, there were 52% male and 48% female. Patient’s distribution based on their age groups were as follows; 14 (14%) in 16-40 years, 32 (32%) in 41-60 years, and 54 (54%) in ≥60 years. Hypertension, diabetes, and congestive heart failure were the most prevalent comorbidities found in 74%, 56%, and 38%, respectively. Statins, proton pump inhibitors, and non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin were the most prevalent prescribed medication given to 69% vs. 71%, 43% vs. 40%, and 29% vs. 17%, respectively. No significant variance was seen in terms of non-gastrointestinal bleeding (NGIB) and risk of ischemic stroke between both groups.
Conclusion: The present investigation observed that the rivaroxaban and warfarin groups showed no significant variance in the prevention of stroke among NVAF elderly patients. In addition, it demonstrated short- and long-term safety and efficacy in stroke prevention for NVAF patients, and both the agents could be used as anticoagulants.
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Dr Absar Khalid Mir
Shifa International Hospital Islamabad Pakistan
Dr Mohammad Ahmad Abbasi
Rashid Latif Khan University Medical College Lahore, Punjab, Pakistan
Dr Laiba Mustansar Sahi
Lahore Medical and Dental College, Lahore
Dr Samana Batool
Shifa College of Medicine/ Shifa International Hospital Islamabad Pakistan.
Dr Muhammad Bilal Anwar
Shifa College of Medicine/ Shifa International Hospital Islamabad Pakistan.
Dr Tehreem Ali
RLKU Medical College Lahore, Pakistan.
Dr Abeera Kazmi
Shifa College of Medicine/Shifa International Hospital Islamabad Pakistan
Dr Israa Alam
Tbilisi State Medical University
Dr Muhammad Ali Hassan
Shifa College of Medicine/ Shifa International Hospital Islamabad Pakistan