An article reviews a low-dose rivaroxaban use in combination with antiplatelet agents in patients with recent acute coronary syndrome. Rivaroxaban was approved for this indication following the completion of phase 3 clinical trial (ATLAS ACS 2TIMI 51) that compared the efficacy and safety of rivaroxaban 2.5 mg and 5 mg twice daily or placebo in 15 526 patients with acute coronary syndrome with or without ST elevation. Addition of low-dose rivaroxaban to dual antiplatelet therapy resulted in significant reduction in the rate of cardiovascular outcomes but was associated with increased risk of bleeding. Therefore, following acute coronary syndrome patients both with high risk of cardiovascular death or myocardial infarction and low risk of bleeding should be selected for long-term anticoagulation with rivaroxaban.
Acute coronary syndrome, anticoagulation, rivaroxaban.