Another Look at Dual Therapy in Patients with Established Atherosclerosis

Secondary analyses of the COMPASS trial point to similar benefits and risks for two diagnostic subgroups.

Despite the development of effective secondary-prevention therapies for individuals who have clinically apparent atherosclerosis, the residual risk of adverse outcomes remains high. In the manufacturer-sponsored COMPASS trial (NEJM JW Cardiol Oct 2017 and N Engl J Med 2017; 377:1319, the combination of the factor Xa inhibitor rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg/day) for secondary prevention resulted in lower rates of cardiovascular events but higher rates of bleeding than aspirin alone; rivaroxaban alone (5 mg twice daily) was not superior to aspirin. The trialists have now reanalyzed the results in two subgroups: patients with coronary artery disease (CAD; N=24,824) and those with peripheral (or carotid) arterial disease …

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Another Look at Dual Therapy in Patients with Established Atherosclerosis

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Reviewing Author