Combination Antithrombotic Therapy and Prevention of Stroke Subtypes

Compared with aspirin alone, low-dose rivaroxaban plus aspirin appeared to reduce embolic strokes and those of unknown source.

Optimal stroke prevention is based on underlying mechanisms. For antithrombotic therapy, oral anticoagulants traditionally are used for cardioembolic sources and antiplatelets for noncardioembolic sources. A third option is to combine a low-dose anticoagulant with an antiplatelet agent — a strategy assessed in a clinical trial (COMPASS) involving >27,000 patients with stable atherosclerotic disease treated with either the factor Xa inhibitor rivaroxaban (5 mg twice daily), low-dose rivaroxaban (2.5 mg twice daily) plus aspirin 100 mg (R+A), or aspirin alone (100 mg). A 42% reduction in stroke with R+A versus aspirin alone in COMPASS was previously reported (Circulation 2019; 139:1134). Investigators have now examined whether ischemic stroke…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Combination Antithrombotic Therapy and Prevention of Stroke Subtypes

Topics

Reviewing Author