TY - JOUR
T1 - A comprehensive analysis of the effects of rivaroxaban on stroke or transient ischaemic attack in patients with heart failure, coronary artery disease, and sinus rhythm
T2 - the COMMANDER HF trial
AU - COMMANDER HF Investigators
AU - Mehra, Mandeep R.
AU - Vaduganathan, Muthiah
AU - Fu, Min
AU - Ferreira, Joao Pedro
AU - Anker, Stefan D.
AU - Cleland, John G. F.
AU - Lam, Carolyn S. P.
AU - van Veldhuisen, Dirk J.
AU - Byra, William M.
AU - Spiro, Theodore E.
AU - Deng, Hsiaowei
AU - Zannad, Faiez
AU - Greenberg, Barry
PY - 2019/11/21
Y1 - 2019/11/21
N2 - Aim Stroke is often a devastating event among patients with heart failure with reduced ejection (HFrEF). In COMMANDER HF, rivaroxaban 2.5mg b.i.d. did not reduce the composite of first occurrence of death, stroke, or myocardial infarction compared with placebo in patients with HFrEF, coronary artery disease (CAD), and sinus rhythm. We now examine the incidence, timing, type, severity, and predictors of stroke or a transient ischaemic attack (TIA), and seek to establish the net clinical benefit of treatment with low-dose rivaroxaban.Methods and results In this double-blind, randomized trial, 5022 patients who had HFrEF(Conclusions Patients with HFrEF and CAD are at risk for stroke or TIA in the period following an episode of worsening heart failure in the absence of atrial fibrillation. Most strokes are of ischaemic origin and nearly half are either disabling or fatal. Rivaroxaban at a dose of 2.5mg b.i.d. reduced rates of stroke or TIA compared with placebo in this population.
AB - Aim Stroke is often a devastating event among patients with heart failure with reduced ejection (HFrEF). In COMMANDER HF, rivaroxaban 2.5mg b.i.d. did not reduce the composite of first occurrence of death, stroke, or myocardial infarction compared with placebo in patients with HFrEF, coronary artery disease (CAD), and sinus rhythm. We now examine the incidence, timing, type, severity, and predictors of stroke or a transient ischaemic attack (TIA), and seek to establish the net clinical benefit of treatment with low-dose rivaroxaban.Methods and results In this double-blind, randomized trial, 5022 patients who had HFrEF(Conclusions Patients with HFrEF and CAD are at risk for stroke or TIA in the period following an episode of worsening heart failure in the absence of atrial fibrillation. Most strokes are of ischaemic origin and nearly half are either disabling or fatal. Rivaroxaban at a dose of 2.5mg b.i.d. reduced rates of stroke or TIA compared with placebo in this population.
KW - Heart failure
KW - Oral anticoagulation
KW - Stroke
KW - Thrombotic
KW - Transient ischaemic attack
U2 - 10.1093/eurheartj/ehz427
DO - 10.1093/eurheartj/ehz427
M3 - Article
SN - 0195-668X
VL - 40
SP - 3593
EP - 3601
JO - European Heart Journal
JF - European Heart Journal
IS - 44
ER -