Use of rivaroxaban in patients with stroke

Danilo Toni, Antonio Carolei, Valeria Caso, Domenico Consoli, Massimo Del Sette, Domenico Inzitari, Maurizio Melis, Giuseppe Micieli, Leandro Provinciali, Stefano Ricci, Paola Santalucia, Vito Toso

Research output: Contribution to journalArticlepeer-review

Abstract

Rivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects and expert opinions on rivaroxaban therapy management in various situations that a neurologist may encounter when treating patients with an ischemic stroke (including those requiring intravenous or intra-arterial reperfusion therapy) and patients with an intracerebral hemorrhage. Since data from clinical trials and real-life data are missing in some clinical situations, strong recommendations are not always available. Nevertheless, practical guidelines should be adopted to maximize benefits from this oral anti-coagulant.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalNeurological Sciences
DOIs
Publication statusAccepted/In press - Feb 25 2017

Keywords

  • Anti-coagulants
  • Atrial fibrillation
  • Intracerebral hemorrhage
  • Ischemic stroke
  • Rivaroxaban

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health

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