A friend left a message to Hua Zi, asking aspirin and rivaroxaban, both of which are used to prevent blood clots, what is the difference and which is better? Hua Zi replied that aspirin and rivaroxaban have different mechanisms of action, and they can be used in combination, but cannot replace each other .
When blood clots in a blood vessel, it can cause a blood clot, causing a blockage in the blood vessel. However, the formation mechanism of thrombosis is different, and different drugs need to be selected when preventing.
Aspirin is mainly used for thromboprophylaxis in patients with atherosclerosis . Because when atherosclerosis occurs in the arteries, the sclerotic plaque itself is unstable and may rupture. If a plaque ruptures, the exposed plaque contents attract platelets to aggregate, which in turn activates fibrin to form a thrombus.
Aspirin can irreversibly inhibit the aggregation function of platelets , thereby preventing platelet aggregation and activating fibrin when plaque ruptures, preventing the formation of thrombus. It has a good preventive effect on ischemic cardiovascular and cerebrovascular diseases such as myocardial infarction and cerebral infarction caused by atherosclerosis.
Rivaroxaban is a coagulation factor Xa inhibitor , which can selectively block the activation of coagulation factor X to factor Xa and block the coagulation chain. It is mainly used for patients who need long-term immobilization of the lower limbs after hip and knee surgery to avoid venous thrombosis and prevent the occurrence of pulmonary embolism .
Patients with atrial fibrillation cannot pump blood normally because of high-frequency atrial fibrillation, so the blood flow rate in the atrial appendage of the atrium slows down, forming turbulent flow, and it is easy to coagulate into a wall thrombus. When the thrombus falls off, it is easy to block the cerebral arteries, resulting in cerebral infarction. Rivaroxaban can also be used in patients with atrial fibrillation to prevent wall thrombosis and prevent cerebral infarction .
Although both aspirin and rivaroxaban can prevent thrombosis, they have different mechanisms of action and cannot replace each other . Aspirin is mainly used for the prevention of atherosclerosis-related diseases such as myocardial infarction, cerebral infarction, coronary heart disease, and severe carotid artery stenosis. Rivaroxaban is mainly used to prevent pulmonary embolism caused by venous thrombosis and cerebral infarction caused by atrial fibrillation.
If both risk factors are present, aspirin and rivaroxaban can be used in combination . Experiments have confirmed that after the combination of the two, the effect of vascular protection is more significant, and the benefit of patients is increased. However, the combination of the two will also increase the risk of gastrointestinal bleeding , so before the combination of the two, it needs to be evaluated by a doctor and used with caution.
The same type of drugs can be substituted for each other. Aspirin is an antiplatelet drug . If the adverse reactions are too large and cannot be tolerated, similar drugs such as clopidogrel and ticagrelor can replace aspirin.
Rivaroxaban is an anticoagulant drug , and its congeners include warfarin, apixaban, dabigatran and other drugs, which can be used instead.
Both antiplatelet drugs and anticoagulant drugs need to be taken regularly for a long time to play a role in preventing thrombosis . If there are no intolerable serious adverse reactions, it is not recommended to stop or change the drug.