Effects Of Different Doses Of Rivaroxaban On Anticoagulation In Patients With Non-vauricular Fibrillation

OBJECTIVE:The purpose of this study was to observe the effects of different doses of rivaroxaban on the incidence of cerebral embolism,systemic embolism and bleeding events in patients with non valvular atrial fibrillation.To evaluating effctiveness and safety in different doses of rivaroxaban on anticoagulation in patients with non-vauricular fibrillation.Provide an effective and safe dose reference for patients with non valvular atrial fibrillation when using rivaroxaban.METHODS:Ninety-two patiens with non valvular atrial fibrillation were selected from March 2016 to March 2017 in our hospital,They were non-randomly divided into rivaroxaban 15mg/day groud(30 patiens),rivaroxaban 20mg/day groud(30 patiens)and warfarin group(32 patiens).All patiens were observated for six months.The incidence of thromboembolic events and the incidence of bleeding events were recorded in the three groups,and the change of international normalized ratio and prothrombin time.Result:(1)There were not statistically significant between the three groups in gender,age,body mass index,smoking history,hypertension history,diabetes history,previous history of myocardial infarction,peripheral vascular disease,hypertension history,creatinine clearance rate,INR value,CHA2DS2-VASc score,HAS-BLED score and other clinical data(P>0.05).(2)Comparison of three groups of antithrombotic effects:In rivaroxaban 15mg/day group and rivaroxaban 20mg/day group,they occurred one case of lower extremity arterial embolism respectively.There were two cases of embolization in the warfarin group,including one case of cerebral embolism,and one case of lower extremity arterial embolism,there was no pulmonary embolism,cardiac thrombosis,myocardial infarction and all-cause death in the three groups,there was no significant difference between the three groups in the incidence of thrombotic embolism(P>0.05).(3)Safety analysis:There was no significant difference in the incidence of intracranial hemorrhage between the three groups(P>0.05).The incidence of gastrointestinal bleeding was significantly lower in rivaroxaban 15mg/day group than in the rivaroxaban 20 mg/day group and the warfarin group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of gingival bleeding and the incidence of urinary bleeding in rivaroxaban 15mg/day group compared with rivaroxaban 20mg/day group and warfarin group,the difference was not statistically significan(P>0.05).There was no significant difference in the incidence of gastrointestinal bleeding,gingival bleeding and urinary bleeding in rivaroxaban 20mg/day group compared with warfarin group(P>0.05).(4)The change of INR and prothrombin time:After taking medicine,all three sets of INR were standard,and significantly different from the medication before(P<0.05).The prothrombin time of the three groups was prolonged afte taking medicine,but the warfarin group was significantly longer than the other two rivaroxaban groups,the difference was statistically significant(P<0.05).Conclusion:Rivaroxaban 15mg/day,rivaroxaban 20mg/day and warfarin in patients with nonvalvular atrial fibrillation have a good anticoagulant effect.However,the incidence of gastrointestinal bleeding in the rivaroxaban 15mg/day group was significantly lower than in rivaroxaban 20 mg/day group and warfarin group,and the rivaroxaban 15 mg/day was more safe in patients with nonvalvular atrial fibrillation.