Rivaroxaban in patients with a recent acute coronary syndrome event: integration of trial findings into clinical practice

Abstract

Despite significant advances in the management of acute coronary syndrome (ACS) and long-term antiplatelet therapy after an ACS event, patients continue to be at risk of further cardiovascular events. There is evidence that recurrent events are at least partly attributed to the persistent activation of the coagulation system after ACS. Various anticoagulants, including vitamin K antagonists (VKAs) and non-VKA oral anticoagulants, have been evaluated in patients post-ACS, in combination with antiplatelet therapy. The desired outcome would be a further reduction of recurrent cardiovascular events with low or acceptable levels of bleeding complications. Here, we provide an overview of the current clinical trial data of non-VKA oral anticoagulants, focusing on rivaroxaban in particular, for secondary prevention in patients with a recent ACS event.

Keywords:

• acute coronary syndrome
• anticoagulants
• antiplatelet therapy

Acknowledgments

The authors would like to acknowledge Yong-Ling Liu and Abigail Macleod, who provided editorial assistance with funding from Janssen Scientific Affairs, LLC and Bayer HealthCare Pharmaceuticals.

This work was supported by Janssen Scientific Affairs, LLC, and Bayer HealthCare Pharmaceuticals (for editorial support only).

Disclosure

Dr Ossei-Gerning received consultancy fees from Bayer HealthCare and has no conflicts of interest in relation to this manuscript. Dr Nallur Shivu has no conflicts of interests to declare. The authors report no other conflicts of interest in this work.