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.