Rivaroxaban versus warfarin in postoperative atrial fibrillation: Cost-effectiveness analysis in a single-center, randomized, and prospective trial

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorPEREIRA, M. D. P.
dc.contributor.authorLIMA, E. G.
dc.contributor.authorPITTA, F. G.
dc.contributor.authorGOWDAK, L. H. W.
dc.contributor.authorMIOTO, B. M.
dc.contributor.authorCARVALHO, L. N. S.
dc.contributor.authorDARRIEUX, F. C. D. C.
dc.contributor.authorMEJIA, O. A. V.
dc.contributor.authorJATENE, F. B.
dc.contributor.authorSERRANO JR., C. V
dc.date.accessioned2024-03-13T19:53:14Z
dc.date.available2024-03-13T19:53:14Z
dc.date.issued2023
dc.description.abstractObjectives: Postoperative atrial fibrillation is the most common clinical complication after coronary artery bypass graft surgery. It is associated with a high risk of both stroke and death and increases the length of hospital stay and costs. This study aimed to evaluate anticoagulants in postoperative atrial fibrillation. Methods: A single-center, randomized, prospective, and open-label study. The trial was conducted in Heart Institute at University of São Paulo, Brazil. Patients who developed postoperative atrial fibrillation were randomized to anticoagulation with rivaroxaban or warfarin plus enoxaparin bridging. The primary objective was the cost-effectiveness evaluated by quality-adjusted life years, using the SF-6D questionnaire. The secondary end point was the combination of death, stroke, myocardial infarction, thromboembolic events, infections, bleeding, readmissions, and surgical reinterventions. The safety end point was any bleeding using the International Society on Thrombosis and Haemostasis score. Follow-up period was 30 days after hospital discharge. Results: We analyzed 324 patients and 53 patients were randomized. The median cost-effectiveness was $1423.20 in the warfarin group versus $586.80 in the rivaroxaban group (P = .002). The median cost was lower in the rivaroxaban group, $450.20 versus $947.30 (P < .001). The secondary outcome was similar in both groups, 44.4% in warfarin group versus 38.5% in the rivaroxaban group (P = .65). Bleeding occured in 25.9% in the warfarin group versus 11.5% in the rivaroxaban group (P = .18). Conclusions: Rivaroxaban was more cost-effective when compared with warfarin associated with enoxaparin bridging in postoperative atrial fibrillation after isolated coronary artery bypass grafting.eng
dc.description.indexPubMed
dc.description.indexScopus
dc.description.indexDimensions
dc.description.indexDimensions
dc.identifier.citationJTCVS OPEN, v.15, p.199-210, 2023
dc.identifier.doi10.1016/j.xjon.2023.05.006
dc.identifier.issn2666-2736
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58612
dc.language.isoeng
dc.publisherELSEVIER B.V.eng
dc.relation.ispartofJtcvs Open
dc.rightsopenAccesseng
dc.rights.holderCopyright ELSEVIER B.V.eng
dc.subjectanticoagulationeng
dc.subjectcoronary artery bypass surgeryeng
dc.subjectcost-effectiveeng
dc.subjectcostseng
dc.subjectdirect oral anticoagulanteng
dc.subjectpostoperative atrial fibrillationeng
dc.titleRivaroxaban versus warfarin in postoperative atrial fibrillation: Cost-effectiveness analysis in a single-center, randomized, and prospective trialeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcMARCEL DE PAULA PEREIRA
hcfmusp.contributor.author-fmusphcEDUARDO GOMES LIMA
hcfmusp.contributor.author-fmusphcFABIO GRUNSPUN PITTA
hcfmusp.contributor.author-fmusphcLUIS HENRIQUE WOLFF GOWDAK
hcfmusp.contributor.author-fmusphcBRUNO MAHLER MIOTO
hcfmusp.contributor.author-fmusphcLETICIA NEVES SOLON CARVALHO
hcfmusp.contributor.author-fmusphcFRANCISCO CARLOS DA COSTA DARRIEUX
hcfmusp.contributor.author-fmusphcOMAR ASDRUBAL VILCA MEJIA
hcfmusp.contributor.author-fmusphcFABIO BISCEGLI JATENE
hcfmusp.contributor.author-fmusphcCARLOS VICENTE SERRANO JUNIOR
hcfmusp.description.beginpage199
hcfmusp.description.endpage210
hcfmusp.description.volume15
hcfmusp.origemSCOPUS
hcfmusp.origem.dimensionspub.1158578158
hcfmusp.origem.scopus2-s2.0-85162869226
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