Efficacy and Safety of using Rivaroxaban with Coronary Artery Disease Patients: Systematic Review and Meta-Analysis

Background: Rivaroxaban, an oral thing Xa inhibitor, is effective in treating venous thromboembolism, and has been shown to save you thromboembolic activities in atrial fibrillation. Low dose rivaroxaban prevents venous thromboembolism after orthopedic surgical procedures and acute coronary syndrome. Aim: This work aims to determine the efficacy and safety of using rivaroxaban with Coronary Artery Disease (CAD) patients. Materials & Methods: A systematic search was performed over different medical databases to identify Internal Medicine studies, which studied the outcome of the rivaroxaban group versus the Placebo group of CAD patients. We conducted a meta-analysis process on primary efficacy endpoint outcomes (death, Myocardial Infarction "MI", stroke, or severe recurrent ischemia requiring revascularisation), and on secondary safety endpoint outcomes (major, minor bleeding or bleeding requiring medical attention "TIMI"). Results: Six studies were identified involving 61928 patients, with 34172 patients in the rivaroxaban group, and 27756 patients in the placebo group. Our meta-analysis process showed a highly significant decrease in efficacy endpoint outcomes (death, Myocardial Infarction "MI", stroke, or severe recurrent ischemia requiring revascularisation), in the rivaroxaban group compared to the placebo group (p<0.001), but also, we found a highly significant increase in safety endpoint outcomes (major, minor bleeding or bleeding requiring medical attention"TIMI"), in the rivaroxaban group compared to the placebo group (p<0.001). Conclusion: To conclude, rivaroxaban may provide an additional therapeutic choice for secondary prevention in patients with CAD. However, to accurately assess the risk of cardiovascular ischemic and bleeding events, we need further studies to gain benefit from rivaroxaban use.