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Anticoagulation in Patients with Ischaemic Heart Disease and Peripheral Arterial Disease: Clinical Implications of

Josep Gradolí1, Verónica Vidal1, Adrian Jb Brady2

  • 1Department of Cardiology, Hospital General Universitario, University of Valencia Valencia, Spain.

European Cardiology
|January 31, 2019
PubMed

Insights

Adding rivaroxaban, a novel oral anticoagulant, to aspirin significantly reduced cardiovascular events in patients with established cardiovascular disease. This combination therapy proved effective without increasing major bleeding risks, offering a new prevention strategy.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Established cardiovascular disease (CVD) patients face ongoing event risks despite optimal treatment.
  • Platelet inhibition is key, but anticoagulant use for atheromatous disease prevention was historically underutilized.
  • Novel oral anticoagulants (NOACs) offer new therapeutic avenues.

Purpose of the Study:

  • To review evidence on anticoagulant therapy for cardiovascular event prevention.
  • To analyze the findings of the Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS) study.
  • To discuss the clinical implications of the COMPASS study for patient management.

Main Methods:

  • Review of existing literature on anticoagulant therapies in CVD.
  • Analysis of data from the COMPASS study, a randomized controlled trial.
  • Evaluation of rivaroxaban plus aspirin versus aspirin alone or other treatments.

Main Results:

  • The COMPASS study demonstrated a significant reduction in cardiovascular events with rivaroxaban plus aspirin.
  • This combination therapy did not elevate the risk of fatal or intracranial bleeding.
  • Rivaroxaban represents a promising anticoagulant for secondary prevention in atheromatous disease.

Conclusions:

  • Combining rivaroxaban with aspirin is an effective strategy for reducing cardiovascular events in high-risk patients.
  • The COMPASS study results support the use of this regimen in clinical practice.
  • Anticoagulant therapy, particularly with NOACs, should be considered for secondary prevention in atheromatous disease.

Keywords:
COMPASSCardiovascular diseasecardiovascular eventsclinical practicenovel oral anticoagulantsrivaroxabansecondary preventionthrombosis

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