Phase 3
Completed N=5,022
A Study to Assess the Effectiveness and Safety of Rivaroxaban in Reducing the Risk of Death, Myocardial Infarction or Stroke in Participants With Heart Failure and Coronary Artery Disease Following an Episode of Decompensated Heart Failure
Source: ClinicalTrials.gov NCT01877915 ↗Enrolled (actual)
5,022
Serious AEs
18.5%
Results posted
May 2019
Primary outcomePrimary: Event Rate of All-Cause Mortality, Myocardial Infarction (MI), or Stroke — 13.44; 14.27 Event rate per 100 patient-year — p=0.270
◆ Published Evidence
Established
97citations · ~14 / year
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: the COMMANDER HF trial.
Summary
The purpose of this study is to assess the effectiveness and safety of rivaroxaban compared with placebo (inactive medication), in reducing the risk of death, myocardial infarction or stroke in participants with heart failure and significant coronary artery disease following an episode of decompensated heart failure.
Linked Publications (5)
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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: the COMMANDER HF trial.
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Natriuretic Peptide-Based Inclusion Criteria in a Heart Failure Clinical Trial: Insights From COMMANDER HF.
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Impact of Geographic Region on the COMMANDER-HF Trial.
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Heart failure re-hospitalizations and subsequent fatal events in coronary artery disease: insights from COMMANDER-HF, EPHESUS, and EXAMINE.
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Cardiovascular effects of rivaroxaban in heart failure patients with sinus rhythm and coronary disease with and without diabetes: a retrospective international cohort study from COMMANDER-HF.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Event Rate of All-Cause Mortality, Myocardial Infarction (MI), or Stroke |
13.44; 14.27 | 0.270 |
| PRIMARY Event Rate of Either Fatal Bleeding or Bleeding Into a Critical Space With Potential for Permanent Disability |
0.22; 0.22; 0.32; 0.48 | 0.951 |
| SECONDARY Event Rate of Cardio Vascular Death or Re-Hospitalization for Worsening of Heart Failure (RHHF) |
23.32; 23.46 | — |
| SECONDARY Event Rate of Cardio Vascular Death |
9.46; 9.96 | — |
| SECONDARY Event Rate of Re-Hospitalization for Worsening of Heart Failure |
17.24; 17.45 | — |
| SECONDARY Event Rate of Re-Hospitalization for Cardio Vascular Events (RHCV) |
13.30; 14.04 | — |
| SECONDARY Event Rate of All-Cause Mortality (ACM) or Re-Hospitalization for Worsening Heart Failure |
24.84; 24.57 | — |
| SECONDARY Event Rate of Bleeding Events That Requiring Hospitalization |
1.52; 1.16 | — |
| SECONDARY Event Rate of International Society on Thrombosis and Haemostasis (ISTH) Major Bleeding Event |
2.04; 1.21 | — |
Eligibility Criteria
Inclusion Criteria
- Must have symptomatic heart failure for at least 3 months prior to Screening
- Participants must have an episode of decompensated heart failure (index event) requiring (a) an overnight stay [that is, staying past midnight] in a hospital, emergency department, or medical facility with the capability of treating with intravenous medications and observing heart failure patients before randomization or (b) an unscheduled outpatient visit to a heart failure management center, where parenteral therapy is required for heart failure stabilization. An episode of decompensated heart failure is defined as symptoms of worsening dyspnea or fatigue, objective signs of congestion such as peripheral edema or ascites, and/or adjustment of pre-hospitalization/outpatient visit heart failure medications. Participants are eligible for randomization at discharge from the facility treating the index event and up to 30 days after discharge if they are in stable condition
- Must have a documented left ventricular ejection fraction (LVEF) of less than or equal to 40 percent (%) within 1 year before randomization
- Must have evidence of significant coronary artery disease
- Must be medically stable in terms of their heart failure clinical status at the time of randomization
- Must have a brain natriuretic peptide (BNP) level greater than or equal to (>=) 200 picogram per milliliter (pg/mL) or N-terminal-proBNP (NT-proBNP) level >=800 pg/mL (preferred assay) during the Screening period and before randomization
Exclusion Criteria
- Any condition that, in the opinion of the investigator, contraindicates anticoagulant therapy or would have an unacceptable risk of bleeding, such as, but not limited to, active internal bleeding, clinically significant bleeding, bleeding at a noncompressible site, or bleeding diathesis within 28 days of randomization
- Severe concomitant disease such as (a) atrial fibrillation (AFib) or another condition that requires chronic anticoagulation (participants with isolated transient AFib may be allowed at the discretion of the treating physician investigator) and (b) Documented acute myocardial infarction (MI) during index event
- Prior stroke within 90 days of randomization
- Has been hospitalized for longer than 21 days during the index event
- Planned intermittent outpatient treatment with positive inotropic drugs administered intravenously
Data sourced from ClinicalTrials.gov (NCT01877915) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.