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Rivaroxaban in Valvular Atrial Fibrillation - a Critical Appraisal of the INVICTUS Trial.

Andreas HammerAlexander NiessnerPatrick Sulzgruber
Published in: Cardiovascular drugs and therapy (2023)
The findings of the INVICTUS trial indicated that rivaroxaban was found to be inferior in efficacy to VKA. However, it is important to note that the primary outcome of the trial was driven by sudden death and death caused by mechanical pump failure. As a result, it is necessary to approach the data from this study with caution, and it would be inappropriate to draw parallel conclusions for other causes of valvular AF. Particularly, the perplexing issue of how rivaroxaban could have contributed to both pump failure and sudden cardiac death requires further explanation. Additional data regarding changes in heart failure medication and ventricular function would be essential for proper interpretation.
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