Abstract
Oral anticoagulation with vitamin-K-antagonists has well known limitations and requires routine clinical monitoring of coagulation parameters. The new oral anticoagulants represent novel direct-acting inhibitors of the coagulation factors IIa (thrombin) or Xa. The compound with the currently widest clinical approval for oral anticoagulation in the group of the Xa inhibitors (also known as the –xabans) is the direct oral factor Xa inhibitor rivaroxaban (Xarelto®). Rivaroxaban was the first direct factor Xa inhibitor with clinical approval for long-term oral anticoagulation in patients with non-valvular atrial fibrillation and has since gained additional approval for the treatment and prevention of deep vein thrombosis and pulmonary embolism. Furthermore, low-dose rivaroxaban, in addition to standard antiplatelet therapy, has been shown to reduce cardiovascular mortality in patients following a recent acute coronary syndrome and recently gained approval for the prevention of atherothrombotic events after acute coronary syndrome by the European Medicines Agency (EMA). This review article discusses the clinical use and benefits of rivaroxaban for multiple indications.
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