© 2017 VitalityCardiology

David Freedman Medicine Professional Corporation

6633 Highway #7 East, Markham

Tel: 905.472.7127   email: Ashgrove@cardiomatters.com

398 Steeles Ave West, Thornhill

Tel: 905.881.0334  email: Steeles@cardiomatters.com

Compass trial January 2018

Combination rivaroxaban  with aspirin cuts the ischemic stroke rate by almost half without significantly increasing the risk for intracerebral hemorrhage (ICH) compared with aspirin alone in patients with stable vascular disease, new research shows.

Indication:

  • 27,000 patients with vascular disease [cad mostly, pad, carotid]

Intervention:

  • ASA 100 vs

  • Rivar 5bid vs

  • Riva 2.5bid/ASA 100

    • .... 25% less MI/CVA/death

    • 70% more bleeding

 

Stopped early at 24 months

That analysis showed that event rates were 4.1% for the combination therapy and 5.4% for aspirin (hazard ratio [HR] for combination vs aspirin, 0.76; 95% confidence interval [CI], 0.66 - 0.86; P < .0001), but major bleeding events occurred in more patients in the combination group (3.1% vs 1.9%; HR, 1.70; 95% CI, 1.40 - 2.05; P < .001).

No difference in fatal bleeds.

PIONEER trial

https://www.medscape.com/viewarticle/871866

.