@article{4fede18acc9642f1b34731197a7b2a29,
title = "Rivaroxaban with or without aspirin in stable cardiovascular disease",
abstract = "BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events.",
keywords = "atherosclerotic vascular disease, Rivaroxaban, Asprin, cardiovascular outcomes, COMPASS trial",
author = "Eikelboom, {J. W.} and Connolly, {S. J.} and J. Bosch and Dagenais, {G. R.} and Hart, {R. G.} and O. Shestakovska and R. Diaz and M. Alings and Lonn, {E. M.} and Anand, {S. S.} and P. Widimsky and M. Hori and A. Avezum and Piegas, {L. S.} and Branch, {K. R.H.} and J. Probstfield and Bhatt, {D. L.} and J. Zhu and Y. Liang and Maggioni, {A. P.} and P. Lopez-Jaramillo and M. O{\textquoteright}Donnell and Kakkar, {A. K.} and Fox, {K. A.A.} and Parkhomenko, {A. N.} and G. Ertl and S. St{\"o}rk and M. Keltai and L. Ryden and N. Pogosova and Dans, {A. L.} and F. Lanas and Commerford, {P. J.} and C. Torp-Pedersen and Guzik, {T. J.} and Verhamme, {P. B.} and D. Vinereanu and Kim, {J. H.} and Tonkin, {A. M.} and Lewis, {B. S.} and C. Felix and K. Yusoff and Steg, {P. G.} and Metsarinne, {K. P.} and Bruns, {N. C.} and F. Misselwitz and E. Chen and D. Leong and S. Yusuf and {COMPASS Investigators} and V. Aboyans and J. Ha and K. Keltai and A. Lamy and L. Liu and P. Moayyedi and M. Sharma and S. Stoerk and J. Varigos and V. Bhagirath and P. Bogaty and F. Botto and L. Catanese and {Donato Magno}, J. and G. Fabbri and I. Gabizon and G. Gosselin and D. Halon and M. Heldmann and P. Lamelas and M. Lauw and Y. Leong and D. Liang and Y. Lutay and M. Maly and R. Mikulik and S. Nayar and K. Ng and K. Perera and O. Pirvu and E. Ronner and S. Sato and A. Smyth and E. Sokolova and M. Wiendl and B. Winkelmann and X. Yang and Y. Yufereva and J. Cairns and P. Sleight and D. DeMets and G. Wong and X. Lu and S. Thomas and G. Niemann and J. Li and T. Simon and A. Nolan and T. Yoshida and {van Leeuwen}, {M. A.} and J. Johnson and S. Lee and J. Anderson and P. Roberts-Thomson and J. Rogers and L. Williams and J. Shaw and C. Lee and C. Hii and J. Selvanayagam and P. Thompson and S. Graves and M. Costa and MAV Silva and M. Chu and L. Hill and T. Anderson and E. Smith and C. Brown and J. Ricci and Stevens, {L. M.} and R. Welsh and S. Robinson and Ross, {M. K.} and M. Nguyen and T. Nguyen and A. Roy and V. Nguyen and S. Nawaz and R. Labont{\'e} and F. Wang and W. Zhang and H. Jiang and C. Chen and Z. Wang and L. Yu and L. Li and S. Wu and H. Yu and S. Liu and H. Cao and Y. Zheng and B. Li and Y. Yang and Z. Xu and H. Yang and X. Chen and X. Tian and R. Zhang and Y. Shi and S. Zhang and Y. Zhao and R. Wang and D. Hu and Y. Wang and C. Li and Y. Chen and C. Wang and S. Lu and X. Zhou and Y. Kong and A. Larsen and N. Mattsson and J. Barton and A. Murphy and Y. Ishii and Y. Nagata and T. Nakai and Lim, {C. W.} and T. Watson and T. Andersson and A. Olsson and B. Liu and A. Maher and P. Davey and A. Ahmed and A. Singh and J. Calvert and J. Carter and D. Austin and M. Jackson and S. Srivastava and J. Hunter and S. Banerjee and S. Sloan and A. Harrison and R. Phillips and R. Black and M. Mccormick and M. Robertson and G. Tulloch and B. Conway and S. Knight and K. Smith and J. Bollen and C. Lewis and A. Magi and B. Miller and A. Rizzo and K. Mehta and E. Martin and L. Mitchell and S. Nelson and K. Boyd and K. Reid and A. Barnett and S. Chen and W. Han and Q. Zhang and W. Li and Z. Huang and D. Liu and S. Tan and S. Martin and C. Klinger and M. Hahn and C. Kelly and M. Hall and M. Joyce and S. Conway and Y. Watanabe and M. Watanabe and Y. Kobayashi and Jaafar, {S. M.} and S. Oliver and H. Kim and J. Lee and K. Yang and S. Kim and K. Johansson and A. Turner and G. Young and J. Gray and D. Campbell and R. Farley and J. Dwyer and M. Craig and D. Scott and L. Schwarz and L. Franklin and L. Ward and S. Bailey and D. Johnson and T. Edwards and C. Cole and S. Cook and S. Fisher and J. Wilson and D. Payne and M. Mccann and A. Sharp",
year = "2017",
month = oct,
day = "5",
doi = "10.1056/NEJMoa1709118",
language = "English",
volume = "377",
pages = "1319--1330",
journal = "New England Journal of Medicine",
publisher = "Massachusetts Medical Society",
number = "14",
}
