Rivaroxaban for stroke prevention in patients with nonvalvular atrial fibrillation and active cancer Journal Article


Authors: Laube, E. S.; Yu, A.; Gupta, D.; Miao, Y.; Samedy, P.; Wills, J.; Harnicar, S.; Soff, G. A.; Mantha, S.
Article Title: Rivaroxaban for stroke prevention in patients with nonvalvular atrial fibrillation and active cancer
Abstract: Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in the general population with nonvalvular atrial fibrillation (AF). However, there is little published evidence on the safety and efficacy of rivaroxaban for AF in patients with active cancer. The aim of this study was to assess the safety and efficacy of rivaroxaban in patients with active cancer and AF. The use of rivaroxaban in patients with cancer at the Memorial Sloan Kettering Cancer Center is monitored in the setting of a Quality Assessment Initiative. Patients with active cancer and AF, treated with rivaroxaban from January 1, 2014, to March 31, 2016, are included in this analysis. Clinical end points were defined a priori and assessed through text searches of medical records. A total of 163 evaluable patients were identified. After adjusting for competing risks, the estimated 1-year cumulative incidence of ischemic stroke was 1.4% (95% CI 0% to 3.4%) and major bleeding was 1.2% (95% CI 0% to 2.9%). The risk of clinically relevant nonmajor bleeding leading to discontinuation of anticoagulation at 1 year was 14.0% (95% CI 4.2% to 22.7%). The cumulative incidence of mortality was 22.6% (95% CI 12.2% to 31.7%) at 1 year, reflecting an active cancer population. One patient died after developing an acute ischemic cerebrovascular insult. In conclusion, the safety and efficacy of rivaroxaban treatment for nonvalvular AF in patients with active cancer is comparable to the results of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET-AF) study in the general population. © 2017 The Authors
Journal Title: American Journal of Cardiology
Volume: 120
Issue: 2
ISSN: 0002-9149
Publisher: Excerpta Medica Inc  
Date Published: 2017-07-15
Start Page: 213
End Page: 217
Language: English
DOI: 10.1016/j.amjcard.2017.04.009
PROVIDER: scopus
PUBMED: 28549819
PMCID: PMC5523442
DOI/URL:
Notes: Article -- Export Date: 3 July 2017 -- Source: Scopus
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MSK Authors
  1. Gerald A Soff
    62 Soff
  2. Simon H Mantha
    33 Mantha
  3. Anthony Yu
    37 Yu
  4. Dipti Gupta
    25 Gupta
  5. Patrick R. Samedy
    8 Samedy
  6. Jonathan   Wills
    21 Wills
  7. Yimei   Miao
    10 Miao
  8. Eva Simona Laube
    4 Laube