A new drug that can potentially help prevent deaths from recurrent heart attacks showed promising results in the latest study published in the New England Journal of Medicine.
The study found that taking the drug rivaroxaban (Xarelto), twice daily orally, reduced deaths from heart attacks and strokes by 9.1 percent as compared to those taking a placebo over an average of 13 months. The trial of 15,526 patients was conducted for those who were hospitalized for an acute coronary syndrome (ACS). All participants were taking a drug to prevent platelet aggregation.
One concerning finding was that patients taking rivaroxaban experienced a bleeding complication four times more often than those taking the placebo. As well, the rate of intracranial bleeding was three times greater for those taking the drug, however, the rate of fatal bleeding was the same in both groups. The increase in bleeding with rivaroxaban is more than counterbalanced by the decrease in cardiovascular deaths.
Using rivaroxaban after an ACS would provide the first opportunity to treat these medical emergencies with drugs that help with both platelet aggregation and coagulation factors as rivaroxaban works by halting one of the intermediates in the complicated cascade of reactions that leads to coagulation of blood.
In 2011 rivaroxaban was approved by the FDA for use in the treatment of two other disorders. There is a good chance the drug will be approved for use following an ACS soon. However, doctors are cautioned to use careful judgment in selecting patients and length of treatment when using this drug to achieve the proper balance between bleeding risks and benefits from reducing cardiovascular events and deaths.
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