Efficacy and Safety of Rivaroxaban versus Warfarin in Patients with Coronary Endarterectomy: A Cross Sectional Study

Coronary endarterectomy is an adjunctive treatment to coronary artery bypass grafting (CABG)in patients with multiple coronary involvements. The aim of the present study was to compare the efficacyand safety of the rivaroxaban versus warfarin in patients undergoing CABG endarterectomy in a prospectiveobservational study.

All the patients who had undergone CABG endarterectomy and had received rivaroxaban or warfarinduring the period from January2019 until August 2021 were included in the study. Need for salvage CABG,major bleeding, and thromboembolic events were considered as primary outcomes. The secondary outcomesincluded all-cause mortality and minor bleeding. All patients were followed for at least six months after theirhospital discharge.

Out of the 73 patients recruited during the 18 months, 45 received rivaroxaban and the remainingpeople received warfarin along with at least one antiplatelet. During the follow-up, no salvage CABG wasperformed. The minor bleeding was comparable between the two groups (31.96 versus 13.27; p=0.21). Therewas no significant difference between warfarin and rivaroxaban in terms of major bleeding and thromboembolicevents (p=0.38 and >0.99, respectively). The all-cause mortality rate was similar between the two groups(p>0.99).

In this preliminary real-word study, rivaroxaban was comparable to warfarin in terms of efficacyand safety in the patients undergoing CABG endarterectomy. Further larger studies are needed to clarify safetyand efficacy of such approach.