Key result
Prolonged dual antiplatelet therapy or dual antithrombotic therapy with low-dose rivaroxaban and aspirin reduces ischemic events in high-risk patients with stable coronary artery disease.
Why the study?
In the absence of head-to-head comparisons, choosing the most appropriate antithrombotic strategy while balancing ischaemia and bleeding risks in high-risk patients with stable coronary artery disease is challenging.
Does prolonged dual antiplatelet therapy or dual antithrombotic therapy reduce major adverse cardiovascular events in high-risk patients with stable coronary artery disease?
Does prolonged dual antiplatelet therapy or dual antithrombotic therapy reduce major adverse cardiovascular events in high-risk patients with stable coronary artery disease?
In high-risk patients with stable CAD, both prolonged DAPT and DATT with low-dose rivaroxaban reduce ischemic events at the cost of increased bleeding, requiring individualized treatment decisions.
May support individualized antithrombotic decisions in high-risk stable CAD; leaves open optimal regimens and net benefit via prospective trials.
Antithrombotic treatment is a key component of secondary prevention following acute coronary syndromes (ACS). Although dual antiplatelet therapy is standard therapy post-ACS, duration of treatment is the subject of ongoing debate. Prolonged dual antiplatelet therapy in high-risk patients with history of myocardial infarction reduced the risk of recurrent myocardial infarction, stroke or cardiovascular death. Similarly, in patients with stable coronary artery disease, two-thirds of whom had a history of myocardial infarction, dual antithrombotic therapy with very-low-dose rivaroxaban and aspirin also resulted in improved ischaemic outcomes. In the absence of head-to-head comparison, choosing the most appropriate treatment strategy can be challenging, particularly when it comes to balancing the risks of ischaemia and bleeding. We aim to review the evidence for currently available antithrombotic treatments and provide a practical algorithm to aid the decision-making process.
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Sumaya et al. (2019) conducted a review in Stable Coronary Artery Disease. Dual Antiplatelet Therapy or Dual Antithrombotic Therapy was evaluated. Prolonged dual antiplatelet therapy or dual antithrombotic therapy with low-dose rivaroxaban and aspirin reduces ischemic events in high-risk patients with stable coronary artery disease.
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