Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 11 3 2023 09 30 158 164 Foroud Shahbazi Department of Clinical Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. Fatemeh Heydarpour Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. Matin Badrbani Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mohammad Azizi Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Amir Kamari Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mostafa Bahremand Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Lida Shojaei Department of Clinical Pharmacy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2023 07 29 2023 09 25 Background: Coronary endarterectomy is an adjunctive treatment to coronary artery bypass grafting (CABG) in patients with multiple coronary involvements. The aim of the present study was to compare the efficacy and safety of the rivaroxaban versus warfarin in patients undergoing CABG endarterectomy in a prospective observational study. Methods: All the patients who had undergone CABG endarterectomy and had received rivaroxaban or warfarin during the period from January2019 until August 2020 were included in the study. Need for salvage CABG, major bleeding, and thromboembolic events were considered as primary outcomes. The secondary outcomes included all-cause mortality and minor bleeding. The patients all were followed for at least six months after their hospital discharge. Results: Out of the 73 patients recruited during the 18 months, 45 received rivaroxaban and the remaining people received warfarin along with at least one antiplatelet. During the follow-up, no salvage CABG was performed. The minor bleeding was comparable between the two groups (31.96 versus 13.27; p=0.21). There was no significant difference between warfarin and rivaroxaban in terms of major bleeding and thromboembolic events (p=0.38 and >0.99, respectively). The all-cause mortality rate was similar between the two groups (p>0.99). Conclusion: In this preliminary real-word study, rivaroxaban was comparable to warfarin in terms of efficacy and safety in the patients undergoing CABG endarterectomy. Further larger studies are needed to clarify safety and efficacy of such approach. https://jpc.tums.ac.ir/index.php/jpc/article/view/605