Early Anti-Coagulation Therapy in New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting: A Randomized Trial Pilot Study
Background
New-onset postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) surgery, increasing the risk of embolism and stroke. This study aimed to compare the feasibility and safety of Warfarin and Rivaroxaban in preventing thrombotic events in POAF patients after isolated CABG.
Methods
A total of 66 patients were randomized to receive either Rivaroxaban or Warfarin. Major bleeding events within 30 days after discharge were the primary outcome, with secondary outcomes including minor bleeding events and thrombotic episodes. Clinical characteristics, medication regimens, and left atrial diameter were assessed.
Results
No thrombotic episodes were observed in either treatment arm, and no major bleeding events occurred in either group. Four minor bleeding events were reported, with no significant difference between the treatment groups. Patients with atrial fibrillation had significantly larger left atrial diameters compared to those with normal sinus rhythm.
Conclusions
This pilot study suggests that Warfarin and Rivaroxaban are both safe and effective for preventing thrombotic episodes in POAF patients after isolated CABG. No significant differences in major bleeding events were observed between the two anticoagulants. These findings may support the preference for DOACs like Rivaroxaban due to their convenience and easier maintenance.
Trial Registration
Number IRCT20200304046696N1, Date 18/03/2020 irct.behdasht.gov.ir
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