COMMANDER HF: Rivaroxaban Not Linked with Improved Outcomes in HF

Rivaroxaban at 2.5mg twice daily was no assocaited with an improvement in rates of death, myocardial infarction (MI), or stroke in patients with worsening chronic heart failure (HF), according to researchers from the COMMANDER HF trial.  

The randomized, double-blind trial included 5,022 patients with chronic HF, LVEF of 40% or less, coronary heart disease, no atrial fibrillation, and elevated plasma concentrations. Patients were randomly assigned to either rivaroxaaban 2.5 mg twice daily or placebo, with a composite endpoint of death from any cause, MI, or stroke. Patients were followed up for a mean of 21.1 months. 

According to the results, the endpoint occurred in 25% of the 2,507 patients taking rivaroxaban, and 26.2% in the 2,515-patient placebo group (P=0.27). The researchers also reported no significant differences in all-cause mortality between the study groups (21.8% rivaroxaban vs. 22.1% placebo; HR=0.98; 95% CI, 0.87 to 1.10). There were also no reported differences between study groups for the primary safety outcome (P=0.48).  

“In patients with recent worsening of chronic heart failure and reduced ejection fraction who also had underlying coronary artery disease and were not in atrial fibrillation, low-dose rivaroxaban added to guideline-based therapy was not associated with a lower rate of the composite outcome of death from any cause, MI, or stroke than placebo, nor did it favorably influence the rate of rehospitalization for HF,” the authors wrote in their conclusion. 

Source: New England Journal of Medicine 

Eric Raible is editor of the Cardiology section of DocWire News and has more than a decade’s worth of experience in covering and publishing in the cardiology space. Eric has previously served as a founding editor of CardioSource WorldNews, and is a former staff writer and editor of Cardiology Today.