Future cardiology
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Randomized Controlled Trial Multicenter Study
Rivaroxaban in atrial fibrillation cardioversion: insights from the X-VeRT trial.
ABSTRACT Vitamin K antagonists (VKAs) have traditionally been the standard of care for the thromboprophylactic anticoagulation of patients with nonvalvular atrial fibrillation (NVAF) undergoing cardioversion. X-VeRT was the first prospective trial to explore the safety and efficacy of one of the non-VKA oral anticoagulants, rivaroxaban, compared with dose-adjusted VKA as thromboprophylaxis in patients with NVAF scheduled to undergo cardioversion. ⋯ Rivaroxaban use (20 mg once daily or 15 mg if creatinine clearance was 30-49 ml/min) was associated with a similar incidence of adverse cardiovascular events and bleeding as VKA use; however, rivaroxaban significantly reduced the time to cardioversion in those undergoing delayed cardioversion. Thus, rivaroxaban is a safe alternative to VKAs for thromboprophylaxis in patients with NVAF undergoing elective cardioversion.
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Randomized Controlled Trial
ODYSSEY MONO: effect of alirocumab 75 mg subcutaneously every 2 weeks as monotherapy versus ezetimibe over 24 weeks.
ABSTRACT Alirocumab is a fully human monoclonal antibody to PCSK9. The ODYSSEY MONO study was the first alirocumab Phase III study to test a previously unused dose of 75 mg subcutaneously every 2 weeks in a population on no lipid-lowering therapy. ⋯ At the week-24 primary end point, the alirocumab intent-to-treat group showed a 47.2% (least square [LS] mean) reduction in LDL-cholesterol compared with a 15.6% (LS mean) reduction with ezetimibe (LS mean difference of 31.6%; p < 0.0001). Safety parameters and adverse events were similar between the two groups.