COMPASS: A New Place for Rivaroxaban in Chronic Ischemic Heart Disease

Combining low doses of rivaroxaban and aspirin seems to be the best strategy for patients with stable chronic ischemic heart disease, according to this new study presented at the European Society of Cardiology Congress 2017, which was published simultaneously in the New England Journal of Medicine.

COMPASS: un nuevo lugar para el rivaroxaban en cardiopatía isquémica crónica

Compared with low-dose aspirin alone, the combination of aspirin and rivaroxaban reduced the primary endpoint, a composite of cardiovascular death, acute myocardial infarction, or stroke through a follow-up of 2 years (4.1% vs. 5.4%; hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.66-0.86).

 

This came at the obvious cost of significantly increased major bleeding (3.1% vs. 1.9%; HR: 1.70; 95% CI: 1.40-2.05). However, net clinical benefit still favors the rivaroxaban-aspirin combination.


Read also: “Ad Hoc” PCI during TAVR: No Impact on Safety or Long Term Outcomes”.


The COMPASS study was conducted at 602 centers in 33 countries and includes 27,395 patients with coronary disease, peripheral vascular disease, or both. These subjects were randomized to rivaroxaban 2.5 mg twice daily plus aspirin 100 mg once daily, rivaroxaban 5.0 mg twice-daily alone, or aspirin 100 mg once-daily alone. Patients who were not under treatment with a proton pump inhibitor were also randomized to pantoprazole or placebo.

 

In addition to the benefit observed as regards the primary endpoint, the combination of rivaroxaban and aspirin reduced the rates of other study endpoints, such as ischemic stroke, acute myocardial infarction, acute lower limb ischemia, or death from coronary causes.


Read also: Pacemaker Implantation After TAVI Raises Costs But Not the Incidence of Adverse Events”.


Rivaroxaban monotherapy did not exhibit any advantages over aspirin alone.

 

Original title: Rivaroxaban With or Without Aspirin in Stable Cardiovascular Disease.

Presenter: Eikelboom JW.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

STEACS and the Use of Bivalirudin vs. Heparin: In Search of BRIGHT-4 Outcomes

Various studies and registries have previously shown the impact of post-percutaneous coronary intervention (PCI) complications on the survival of patients with ST-segment elevation acute...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

Ultrathin vs Thin-Strut Stents in PCI Patients at High Bleeding Risk

Several in vivo studies have shown that ultrathin stents present lower thrombogenic risk vs. thin-strut stents, which reflects in lower rates of target lesion...

Should We Withdraw Anticoagulation Before TAVR?

Approximately one-third of patients undergoing transcatheter aortic valve replacement (TAVR) have atrial fibrillation and are on oral anticoagulant (OAC) therapy. This creates a complex...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...