Objective To explore the anticoagulation efficacy and safety of low-dose rivaroxaban in elderly patients with non-valvular atrial fibrillation (NVAF).

Methods 450 patients aged ≥80 years old with NVAF who took oral warfarin or rivaroxaban in Qidong People's Hospital from January 2018 to January 2020 were selected. They were divided into warfarin group (group A, n=156), rivaroxaban 15 mg group (group B, n=143), and rivaroxaban 10 mg group (group C, n=151). The patients in the three groups treated 12 months, and the coagulation function before and after treatment, and rates of embolism, bleeding and adverse reactions were compared among the three groups.

Results Before treatment, there was no significant difference in plasma prothrombin time (PT), international normalized ratio (INR), thrombin time (TT) and activated partial thromboplastin time (APTT) among the three groups. Two months after treatment, PT, INR, TT and APTT of the elderly NVAF patients in the three groups were prolonged (P < 0.05), and were prolonged more in group B and group C (P < 0.05), PT, INR and APTT of patients prolonged more in group B than those in group C (P < 0.05). The total incidence of embolism events in group A, group B, and group C were 4.49%, 4.20%, and 5.30%, respectively, with no statistically significant difference. The total incidences of bleeding events and adverse reactions in group A, group B, and group C were 11.54%, 5.59%, 3.97%, and 19.23%, 10.49%, and 8.61%, respectively. The total incidences of bleeding events and adverse reactions in group C were significantly lower than those in group A (P < 0.05), and there was no statistically significant difference between group B and group A, and between group B and group C.

Conclusion In elderly NVAF patients aged ≥80 years, the low-dose (10 mg) rivaroxaban has better anticoagulation efficacy and safety compared to warfarin, and the effect of preventing embolism and safety are not worse than that of conventional dose (15 mg) rivaroxaban.