Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F17%3A73601055" target="_blank" >RIV/61989592:15110/17:73601055 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/17:43915167 RIV/00064173:_____/17:N0000138 RIV/00209775:_____/17:N0000032

Result on the web

<a href="https://www.nejm.org/doi/10.1056/NEJMoa1709118" target="_blank" >https://www.nejm.org/doi/10.1056/NEJMoa1709118</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1056/NEJMoa1709118" target="_blank" >10.1056/NEJMoa1709118</a>

Result language

angličtina

Original language name

Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease

Original language description

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&lt; 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&lt; 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.

Czech name

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Czech description

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Type

J_SC - Article in a specialist periodical, which is included in the SCOPUS database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

NEW ENGLAND JOURNAL OF MEDICINE

ISSN

0028-4793

e-ISSN

—

Volume of the periodical

377

Issue of the periodical within the volume

14

Country of publishing house

US - UNITED STATES

Number of pages

12

Pages from-to

1319-1330

UT code for WoS article

000412375000012

EID of the result in the Scopus database

2-s2.0-85029804845