Efficacy and Safety of Variable Rivaroxaban Doses in Elderly Patients with Non-Valvular Atrial Fibrillation

<h2 id="background">Background &amp; Objective</h2><ul><li>Atrial fibrillation increases stroke risk &gt; 5-fold in elderly patients.</li><li>This study evaluates associations between rivaroxaban doses (low: 10 mg/day vs. standard: 15-20 mg/day) and clinical outcomes in elderly NVAF patients and identifies factors influencing dose selection.</li></ul><h2 id="methods">Methods</h2><ul><li><strong>Study Design:</strong> Single-center retrospective analysis</li><li><strong>Population:</strong> 214 elderly patients (≥65 years) with NVAF hospitalized January-December 2022</li><li><strong>Intervention:</strong> Rivaroxaban therapy categorized in standard-dose group (15-20 mg/day) and a low-dose group (10 mg/day)</li><li><strong>Outcomes:</strong> 12-month follow-up for thromboembolic events, bleeding, all-cause mortality, and cardiovascular readmission</li><li><strong>Analysis:</strong> Propensity score matching, multivariate logistic regression</li></ul><h2 id="results">Results</h2><p><strong>Baseline Characteristics</strong></p><ul><li>Low-dose group (n=84): Older (79.2 ± 8.2 years), higher bleeding history (21.42%)</li><li>Standard-dose group (n=130): Younger (75.4 ± 8.0 years), lower bleeding history (7.79%)</li><li>No significant differences in sex, CHA2DS2-VASc score, HAS-BLED score, or comorbidities&nbsp;</li><li>Clinical Outcomes Comparison Between Rivaroxaban Dose Groups is shown in Table.</li></ul><figure class="image"><img style="aspect-ratio:838/199;" src="https://cdn.megawecare.com/GHBY/Internal-Images/clinical-outcomes-at-12-month-follow-up.webp" alt="Clinical Outcomes at 12-Month Follow-up" width="838" height="199"></figure><ul><li>Standard-dose group demonstrated higher 12-month cumulative survival (HR = 0.61; 95% CI: 0.39-0.95; P= 0.03) in unadjusted analysis, which was eliminated after propensity score matching (adjusted HR = 0.75; P = 0.21).</li></ul><h2 id="conclusion" data-section="conclusion">Conclusion</h2><ul><li>Low-dose rivaroxaban demonstrated equivalent efficacy and safety to standard dosing for thromboembolic prevention and bleeding control in elderly NVAF patients.</li><li>Apparent survival advantage of standard dosing was attributable to baseline confounders.&nbsp;</li><li>Age, bleeding history, and renal function should guide individualized anticoagulation strategies.</li></ul>

Cardiology Update 2   Issue 1   Jan 2026

<ul><li><a href="#background">Background &amp; Objective</a></li><li><a href="#methods">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Efficacy and Safety of Variable Rivaroxaban Doses in Elderly Patients with Non-Valvular Atrial Fibrillation

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