Low-dose Rivaroxaban: is it a safe alternative in Chinese older patients?

Purpose 10 mg rivaroxaban is widely used in the Chinese mainland. This study aims to explore the association between 10 mg once daily rivaroxaban and all-cause mortality in patients with nonvalvular atrial fibrillation (NVAF). Methods This observational study enrolled 1131 NVAF patients at the cardiovascular department of the First Affiliated Hospital of Xi’an Jiaotong University. One-year outcomes included all-cause mortality and bleeding were recorded. Cox proportional hazards models and Kaplan-Meier analysis were utilized in the study. Results In total, 1131 patients (402 no anticoagulants, and 729 rivaroxaban) were included. Cox proportional hazard analysis demonstrated that low-dose rivaroxaban (10 mg, HR: 0.14, 95% CI:(0.07–0.28), P <0.001; 15 mg, HR: 0.20, 95% CI:(0.09–0.43), P <0.001; 20 mg, HR: 0.22, 95% CI:(0.05–0.96), P = 0.044) exhibited lower mortality risk compared to untreated patients. Conclusions 10 mg once daily rivaroxaban may provide survival benefits for elderly patients with NVAF.