Abstract 11890: Serial Changes of Inflammatory Markers in Patients Treated With Rivaroxaban or Dabigatran: An Interim Report of the RIVAL-AF Study
Background: Some experimental studies showed that factor Xa inhibitors have the anti-inflammatory effects and prevent progression of atherosclerotic lesions, although direct thrombin inhibitors may increase the inflammatory markers. However, serial changes of inflammatory markers in patients receiving novel oral anticoagulants remain unknown.
Methods: In this multicenter randomized study, a total of 141 patients with atrial fibrillation were randomly assigned to rivaroxaban (n=71) or dabigatran (n=70) treatment. As an interim analysis, we evaluate the levels of inflammatory markers including high sensitivity C-reactive protein (hsCRP), pentraxin-3 (PTX3), interleukin (IL)-6, IL-18 and thrombomodulin (TM) at baseline, 1 month, and 3 months after randomization.
Results: There were no significant differences in baseline characteristics between the groups. Main results are shown in charts. In both groups, the levels of IL-6 and PTX3 did not change significantly from baseline to 3 months. The median levels of TM increased from baseline to 3 months in rivaroxaban group (2.8 (2.4-3.5) vs 2.9 (2.7-3.7) FU/ml, p<0.01) and in dabigatran group (2.7 (2.4-3.2) vs 3.1 (2.7-3.4) FU/ml, p<0.01). Among 52 patients with CHA2DS2-VASc score >3, in rivaroxaban group (n=27) the hsCRP level decreased from baseline to 3 months (621 (310-3108) vs 454 (160-865) ng/ml, p<0.01), however, it remained at a similar level during study period in dabigatran group (n=25) (694 (406-1600) vs 758 (354-1138) ng/ml, NS).
Conclusions: The hsCRP level decreased and the increase of IL-18 was inhibited after rivaroxaban treatment. Rivaroxaban may have the anti-inflammatory effects in clinical practice.
Author Disclosures: S. Kikuchi: None. K. Tsukahara: None. Y. Morita: None. K. Arakawa: None. T. Endo: None. J. Okuda: None. S. Kobayashi: None. T. Shigemasa: None. R. Sawada: None. M. Shimizu: None. T. Sugano: None. T. Takamura: None. T. Tsunematsu: None. H. Himeno: None. K. Fukui: None. Y. Mochida: None. A. Wada: None. K. Kimura: Research Grant; Significant; Toa Eiyo Ltd, Bayer, MSD, Astellas, Astrazeneca, Sanofi, Eli Lilly Japan, Research Institute for Production Develpoment, Novartis, Pfizer, Shionogi, Kowa-souyaku, Daiichi-Sankyo, Mitsubishi Tanabe, Nihon-Boehringer-Ingelheim, Takeda, Otsuka, Ono. Honoraria; Modest; Astrazeneca. Honoraria; Significant; MSD. S. Umemura: Research Grant; Modest; Torii. Research Grant; Significant; Pfizer, Dainippon-Sumitomo, Astellas, Shionogi, Daiichi-Sankyo, MSD, Astrazeneca, Novartis, Nihon-Boehringer-Ingelheim. Honoraria; Modest; Shionogi, MSD, Kyowa-Hakko-Kirin.
- © 2014 by American Heart Association, Inc.