Key result
Rivaroxaban combined with ASA decreased the risk of stroke, cardiovascular death, and myocardial infarction by 24% compared to ASA monotherapy in patients with established atherosclerotic diseases.
Why the study?
Secondary prevention of atherothrombotic stroke remains an urgent medical and social problem.
Does rivaroxaban in combination with acetylsalicylic acid reduce the composite of stroke, cardiovascular death, and myocardial infarction in patients with established atherosclerotic diseases compared to acetylsalicylic acid monotherapy?
Does rivaroxaban in combination with acetylsalicylic acid reduce the composite of stroke, cardiovascular death, and myocardial infarction in patients with established atherosclerotic diseases compared to acetylsalicylic acid monotherapy?
Effect estimate: 24% decrease
Combination therapy with rivaroxaban and ASA provides significant clinical benefits over ASA monotherapy for the secondary prevention of atherothrombotic stroke in patients with established atherosclerotic disease.
May support dual antithrombotic regimens in secondary stroke prevention; leaves open optimal selection and bleeding management in routine care.
The article is devoted to an urgent medical and social problem - secondary prevention of atherothrombotic stroke and contains current evidence on the use of combined antiplatelet and anticoagulant therapy. In the COMPASS study, the dual-pathway thrombosis inhibition scheme using rivaroxaban in combination with acetylsalicylic acid (ASA) compared with ASA monotherapy demonstrated in patients with established atherosclerotic diseases of the circulatory system, a decrease in the total risk of stroke, death from cardiovascular causes and myocardial infarction by 24%; reduced risk of recurrent stroke by 67%. The incidence of repeated ischemic stroke (IS) in the combination therapy group was 1.1% per year, in the ASA group - 3.4% per year. The total incidence of adverse outcomes included in the combined indicator «net clinical benefit» in the rivaroxaban group in combination with ASA was 20% lower than in the ASA group and confirms the advantages of combination therapy in the prevention of recurrent noncardioembolic IS.
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M. Yu. Maksimova (2021) conducted a review in Atherosclerotic diseases of the circulatory system. Rivaroxaban in combination with acetylsalicylic acid (ASA) vs. ASA monotherapy was evaluated on Stroke, death from cardiovascular causes and myocardial infarction (24% decrease). Rivaroxaban combined with ASA decreased the risk of stroke, cardiovascular death, and myocardial infarction by 24% compared to ASA monotherapy in patients with established atherosclerotic diseases.
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