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Rivaroxaban Versus Warfarin in the Evaluation of Progression of Coronary Calcium

Atherosclerosis Clinical Trial

Official title:
Rivaroxaban Versus Warfarin in the Evaluation of Progression of Coronary Calcium

Clinical Trial 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.

Clinical Trial Description

Rivaroxaban is a novel oral direct factor Xa inhibitor that has been shown to reduce the risk of stroke in a similar population in comparison with warfarin. The rate of myocardial infarction was 9% lower in the rivaroxaban group than in the warfarin group in the Rocket AF study and similarly the myocardial infarction rate was 12% lower in the apixaban group in Aristotle, but the difference was not significant in either trial. The potential of long term benefit by avoiding VKA therapy may be much greater for a CV event reduction. The study proposed will evaluate markers of CAC progression and atherosclerosis development, which have long term outcome data supporting that slowing these processes will be associated with lower CV events. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details
NCT number NCT02376010
Study type Interventional
Source Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
Contact
Status Completed
Phase Phase 4
Start date April 2, 2015
Completion date April 1, 2018
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