COMPASS for Vascular Surgeons: Practical Considerations
- PMID: 30543542
- DOI: 10.1097/HCO.0000000000000597
COMPASS for Vascular Surgeons: Practical Considerations
Abstract
Purpose of review: To suggest a practical approach for the application of data from the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial in patients with peripheral artery disease (PAD).
Recent findings: The COMPASS trial showed that low-dose rivaroxaban 2.5 mg twice daily plus daily aspirin was superior to aspirin alone in reducing major adverse cardiovascular and cerebrovascular events, and major adverse limb events among patients with stable atherosclerotic vascular disease, including those with PAD. The risk for major bleeding, however, was higher with rivaroxaban plus aspirin. Critical limb ischemia at baseline (rest pain, ulcer, or gangrene), previous limb or foot amputation, or a history of peripheral revascularization surgery or stenting were independently associated with increased major adverse limb events within the trial.
Summary: Intensification of antithrombotic therapy with low-dose rivaroxaban plus aspirin should be considered in low bleeding risk PAD patients who are at increased risk for ischemic and/or limb events. A practical approach for clinicians is presented to help incorporate COMPASS data into practice.
Similar articles
-
Major Adverse Limb Events and Mortality in Patients With Peripheral Artery Disease: The COMPASS Trial.J Am Coll Cardiol. 2018 May 22;71(20):2306-2315. doi: 10.1016/j.jacc.2018.03.008. Epub 2018 Mar 11. J Am Coll Cardiol. 2018. PMID: 29540326 Clinical Trial.
-
Rivaroxaban and Aspirin in Patients With Symptomatic Lower Extremity Peripheral Artery Disease: A Subanalysis of the COMPASS Randomized Clinical Trial.JAMA Cardiol. 2021 Jan 1;6(1):21-29. doi: 10.1001/jamacardio.2020.4390. JAMA Cardiol. 2021. PMID: 32997098 Free PMC article. Clinical Trial.
-
Editor's Choice - External Applicability of the COMPASS and VOYAGER-PAD Trials on Patients with Symptomatic Lower Extremity Artery Disease in France: The COPART Registry.Eur J Vasc Endovasc Surg. 2021 Sep;62(3):439-449. doi: 10.1016/j.ejvs.2021.05.028. Epub 2021 Jul 28. Eur J Vasc Endovasc Surg. 2021. PMID: 34330647
-
Rivaroxaban versus Clopidogrel for Peripheral Artery Disease: A Clinico-Economic Approach of the COMPASS Trial.Curr Pharm Des. 2018;24(38):4516-4517. doi: 10.2174/1381612825666190101100832. Curr Pharm Des. 2018. PMID: 30621559 Review.
-
How can the results of the COMPASS trial benefit patients with coronary or peripheral artery disease in Poland?Kardiol Pol. 2019 Aug 23;77(7-8):661-669. doi: 10.33963/KP.14855. Epub 2019 May 30. Kardiol Pol. 2019. PMID: 31144674 Review.
Cited by
-
Pharmacological interventions for asymptomatic carotid stenosis.Cochrane Database Syst Rev. 2023 Aug 4;8(8):CD013573. doi: 10.1002/14651858.CD013573.pub2. Cochrane Database Syst Rev. 2023. PMID: 37565307 Free PMC article. Review.
-
Long term efficacy and safety of rivaroxaban plus cilostazol in the treatment of critical ischemia of the lower limbs in a frail, elderly patient with non valvular atrial fibrillation.J Pharm Health Care Sci. 2020 Aug 3;6:17. doi: 10.1186/s40780-020-00173-9. eCollection 2020. J Pharm Health Care Sci. 2020. PMID: 32774874 Free PMC article.
-
Reducing residual thrombotic risk in patients with peripheral artery disease: impact of the COMPASS trial.Drugs Context. 2020 Jul 6;9:2020-5-5. doi: 10.7573/dic.2020-5-5. eCollection 2020. Drugs Context. 2020. PMID: 32699549 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials