Phase 4
N=110
Rivaroxaban Versus Warfarin in the Evaluation of Progression of Coronary Calcium
Atherosclerosis
Bottom Line
View on ClinicalTrials.gov: NCT02376010 ↗Enrolled (actual)
110
Serious AEs
0.0%
Results posted
Jul 2021
Primary outcome: Primary: Coronary Artery Calcium (Serial Calcium Scans) — 26.3; 40.5 mm cubed
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- rivaroxaban (Drug); Warfarin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
- Primary completion
- Apr 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Coronary Artery Calcium (Serial Calcium Scans) |
26.3; 40.5 | — |
| SECONDARY Atherosclerotic Plaque (Measures of Total Atherosclerosis Plaque on Serial CCTA) |
20.1; 30.1 | — |
Summary
Current oral anti-coagulation for atrial fibrillation is most commonly performed with warfarin. Warfarin is a vitamin K antagonist that has been shown in non-randomized trials to increase vascular calcification. Increased vascular calcification has been tied to increased cardiovascular events (CVE). This study will randomize patients currently taking warfarin to either continue on warfarin or be switched to rivaroxaban. Rivaroxaban is an oral anti-coagulant that works by inhibiting Factor Xa, and has no interaction with vitamin K. This study is a randomized, open label study that will randomize 120 patients and have them undergo blood tests and a calcium scan at baseline, and again after 12 months. Patients will be seen quarterly for examinations, safety checks and supply of rivaroxaban, as well as follow up INR testing for warfarin.
Eligibility Criteria
Key Inclusion Criteria
- Eligible patients with atrial fibrillation at enrollment or two or more episodes of atrial fibrillation or flutter, as documented by electrocardiography, at least 2 weeks apart in the 12 months before enrollment
- Age 18-84
- On Warfarin for 6 months prior to enrollment at a stable dose.
- Willingness to participate in the study and ability to sign informed consent
- Minimum CAC score of 10
Key Exclusion Criteria
- Atrial fibrillation due to a reversible cause, moderate or severe mitral stenosis, or conditions other than atrial fibrillation that require anticoagulation (e.g., a prosthetic heart valve)
- Prior apixaban, dabigatran, rivaroxaban use.
- A need for aspirin at a dose of >165 mg a day or for both aspirin and clopidogrel,
- Renal insufficiency (serum creatinine level of 12.5 mg per deciliter or calculated creatinine clearance of 170mmHg or diastolic blood pressure of >110 mmHg).
- History of active malignancy requiring concurrent chemotherapy.
- Any unstable medical, psychiatric, or substance abuse disorder that in the opinion of the principal investigator is likely to affect the subject's ability to complete the study.
- Known allergy to iodinated contrast material
- Pregnancy or breast feeding
Data sourced from ClinicalTrials.gov (NCT02376010). 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.