Key result
Rivaroxaban and aspirin reduce myocardial infarction, stroke, and cardiovascular death in patients with coronary artery disease, without affecting bypass graft patency in the first postoperative year.
Why the study?
To review the COMPASS trial and provide practical guidance on selecting patients after CABG who have the greatest potential to benefit with acceptable bleeding risk.
Does the combination of rivaroxaban and aspirin reduce atherothrombotic events in patients after coronary artery bypass surgery?
Does the combination of rivaroxaban and aspirin reduce atherothrombotic events in patients after coronary artery bypass surgery?
The COMPASS regimen (rivaroxaban and aspirin) should be considered for indefinite use in post-CABG patients at high risk of thrombosis and acceptable bleeding risk to prevent long-term atherothrombotic events.
PURPOSE OF REVIEW: We review the cardiovascular outcomes for people using anticoagulation strategies (COMPASS) trial with particular emphasis on patients with a history of remote coronary artery bypass grafting (CABG) and those who were enrolled 4-14 days after CABG. We provide practical guidance for selecting patients with the greatest potential to benefit who have acceptable bleeding risk. In particular, we address concerns about postoperative bleeding and discuss the relative merits of rivaroxaban and aspirin versus P2Y12 inhibition and aspirin. RECENT FINDINGS: The COMPASS trial demonstrated that rivaroxaban and aspirin reduce myocardial infarction, stroke, and cardiovascular death in patients with coronary artery disease, without a demonstrated effect on bypass graft patency in the first postoperative year. SUMMARY: After CABG, cardiac surgeons should consider using the COMPASS regimen in patients at high risk of thrombosis whose risk of bleeding is acceptable. If used, the COMPASS regimen should be continued indefinitely in conjunction with other pharmacological risk reduction therapies to prevent long-term atherothrombotic events.
No takes yet. Share an insight, caveat, or question.
Eikelboom et al. (2020) conducted a review in Coronary artery disease post-CABG. Rivaroxaban and aspirin was evaluated on Myocardial infarction, stroke, and cardiovascular death. Rivaroxaban and aspirin reduce myocardial infarction, stroke, and cardiovascular death in patients with coronary artery disease, without affecting bypass graft patency in the first postoperative year.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: