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For the past 10 years, the introduction of rivaroxaban in clinical practice has produced dramatic changes in lives of patients affected by thrombotic disorders. In this review, we discuss rivaroxaban’s pharmacokinetic properties, focusing on the issues of interactions with other drugs and on the appropriate clinical use of coagulation tests in patients treated with this drug. We also examine the many clinical scenarios in which rivaroxaban was tested. In particular, results of studies on venous thromboembolism (VTE) prevention in orthopaedic surgery, deep vein thrombosis (DVT) and pulmonary embolism (PE) acute and long-term treatment with a focus on cancer patients, stroke prevention in atrial fibrillation (AF) with a special mention for cardioversion and trans-catheter ablation and atherosclerotic cardiovascular disease are presented. Our objective is to provide a summary of the evidence in order for the physician to be able to critically apply this information to patients’ management in everyday clinical practice.
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