Abstract
Purpose: To evaluate the effectiveness and associated risks of rivaroxaban against warfarin in Chinese elderly diabetic patients with non-valvular atrial fibrillation.Methods: Data regarding demographical characteristics, clinical conditions, ischemic stroke, intracranial bleeding, gastrointestinal tract bleeding, myocardial infractions, hip/pelvic fracture, asthma, breast/prostate cancer, and death during 3-years of treatment of 584 Chinese diabetic patients with confirmed non-valvular atrial fibrillation who were placed on rivaroxaban (RX Cohort, n = 201) or warfarin (WF Cohort, n = 383) were collected from hospital records and analyzed. Multivariate analysis was performed for the prediction of the incidence of the treatment-emergent event(s).Results: During the 3-year treatment period, higher numbers of patients were reported for intracranial bleeding (p = 0.042), ischemic stroke (p = 0.042), gastrointestinal bleeding (p = 0.0006), hip/pelvic fracture (p = 0.042), and asthma (p = 0.0007) in WF cohort than RX cohort. Also, higher mortality was reported in WF cohort than for RX cohort (24 vs. 4, p = 0.024). Female sex (p = 0.031), age (p = 0.035), and comorbidities (p = 0.021) were associated with incidence of treatment-emergent event(s).Conclusion: With rivaroxaban, a significant and safe risk-reduction of thromboembolic events are found in elderly diabetic patients with non-valvular atrial fibrillation.
 Keywords: Anticoagulant, Diabetes, Non-valvular atrial fibrillation, Rivaroxaban, Warfarin
Highlights
Diabetes is a common morbidity associated with non-valvular atrial fibrillation [1] and has risk for combined endpoint events and mortality [2]
8 million Chinese people are affected with nonvalvular atrial fibrillation [2]
115 patients were placed on only antiplatelet therapies, so these were excluded from the study and 26 patients who received anticoagulant therapy had reduced kidney functions
Summary
Diabetes is a common morbidity associated with non-valvular atrial fibrillation [1] and has risk for combined endpoint events and mortality [2]. Diabetes has a greater risk of embolic events [3]. Unlike Caucasians, the prevalence of stroke in Chinese patients is associated with non-valvular atrial fibrillation and diabetes [4]. 8 million Chinese people are affected with nonvalvular atrial fibrillation [2]. The current ACC/AHA/HRS (The American College of Cardiology/the American Heart Association/the Heart Rhythm Society) Guideline for the management of patients with non-valvular atrial fibrillation recommends the use of anticoagulants [5] but the use of anticoagulants is less than 10 % in a Chinese population with a history of diabetes. There is a big gap between the recommended guidelines and practice in China because antiplatelet is frequently used instead of anticoagulant agents [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
