Secondary prevention of coronary heart disease and peripheral artery disease combining antiaggregation and anticoagulation therapy. Expert consensus statement of the Czech Society of Cardiology, the Czech Society of Internal Medicine and the Czech Society of Angiology to the outcomes of COMPASS trial
Abstract
The COMPASS study included 7,470 patients diagnosed with peripheral atherosclerotic arterial disease (PAD), patients with stable forms of ICHDK and stabilized patients with atherosclerotic carotid artery disease. In COMPASS, a combination of a small dose of rivaroxaban 2.5 mg daily with ASA 100 mg demonstrated that this treatment significantly reduced the cardiovascular event in the group of patients with peripheral arterial atherosclerosis and favorably influenced the fate of the limb.
The results of the COMPASS study put a big question before medicine: should the recommended guidelines for secondary prevention of ischemic heart disease and ischemic disease of the lower extremities (possibly stroke) change so that a low dose of rivaroxaban is routinely added to ASA? The authors of this expert opinion prepared by the three expert societies agree that current medicine has antithrombotic strategies more effective for secondary prevention than ASA alone, and that the time when ASA monotherapy was the "gold standard" is no longer over. As rivaroxaban now has data from two studies (COMPASS and ATLAS ACS2), both of which have shown a statistically significant reduction in overall mortality, dual combination ASA with rivaroxaban appears to be the most effective way to further improve the fate of these patients.