Atrial Fibrillation
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Renato Lopes, ESC 2022: Rivaroxaban for patients with atrial fibrillation and bioprosthetic mitral valves, the RIVER trial

Published Online: September 20th 2022

The RIVER trial pre-specified analysis presented at ESC 2022 aimed to test the efficacy/safety of rivaroxaban compared to warfarin in patients with atrial fibrillation (AF) and bioprosthetic mitral valves, according to time of valve implantation. In this touchCARDIO interview, we speak with Professor Renato Lopes (Duke University Medical Center, Durham, NC, USA) to discuss non-vitamin K antagonist oral anticoagulants (NOACs), also known as direct oral anticoagulants (DOACs), in patients with AF and bioprosthetic valves as well as the RIVER trial and what questions remain unanswered that require further studies.

The abstract entitled ‘RIVER: Rivaroxaban for Valvular Heart Disease and Atrial Fibrillation’ was presented at the European Society of Cardiology (ESC) Congress 2022, 26 – 29 August 2022.

Questions:

  1. What is known about the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) and bioprosthetic heart valves? (0:18)
  2. What do current ESC guidelines for the diagnosis and management of AF recommend in terms of NOAC usage in patients with prosthetic heart valves? (0:56)
  3. What were the aims, design and inclusion criteria of the RIVER trial? (1:32)
  4. What were the primary and secondary outcome measures and how well were they achieved? (2:32)
  5. What conclusions can be drawn from this study and what further studies are needed? (3:31)

Disclosures: Renato Lopes is on the advisory board for Pfizer, a consultant for Bayer, BMS, Boehringer Ingleheim, Daiichi Sankyo, GSK, Medtronic, Merck, Pfizer, Portola and Sanofi and has received grants or research support from BMS, GSK, Medtronic, Pfizer and Sanofi.

Support: Interview and filming supported by Touch Medical Media. Interview conducted by Danielle Crosby.

Filmed as a highlight of ESC 2022

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