Rivaroxaban for prevention of cardiovascular events following an episode of decompensated heart failure

Chronic heart failure is a long term condition with no cure where the heart is unable to pump blood around the body properly, usually because the heart has become too weak or stiff. Symptoms of heart failure include breathlessness, tiredness and swollen legs and ankles. Heart failure has many different causes including coronary artery disease, where the blood supply to the heart is blocked or interrupted by the build-up of fatty substances in the coronary arteries. Sometimes in chronic heart failure there can be an episode of worsened symptoms which will require immediate or additional treatment called acute decompensated heart failure.
Rivaroxaban is an oral medicine which prevents the development of blood clots by blocking the formation of a molecule called thrombin which is a key part of the process of blood clot formation. Rivaroxaban has the potential to reduce thrombin and blood clot formation in people with heart failure and coronary artery disease. This is potentially important as patients with heart failure after an episode of acute decompensation have been seen to have increased levels of thrombin. No other drug is currently licenced for use in this group of patients which targets thrombin.