1. Rivaroxaban and Aspirin in Peripheral Vascular Disease: a Review of Implementation Strategies and Management of Common Clinical Scenarios
- Author
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Graham R. McClure, Vinai Bhagirath, Eric Kaplovitch, Sonia S. Anand, and Sukrit Narula
- Subjects
medicine.medical_specialty ,Population ,Disease ,030204 cardiovascular system & hematology ,Peripheral Vascular Disease (CJ Cooper and R Gupta, Section Editors) ,Coronary artery disease ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,Fibrinolytic Agents ,Rivaroxaban ,Humans ,Medicine ,Thrombolytic Therapy ,030212 general & internal medicine ,Intensive care medicine ,education ,Aspirin ,education.field_of_study ,Peripheral artery disease ,business.industry ,Vascular disease ,Anticoagulants ,medicine.disease ,COVID-19 Drug Treatment ,Peripheral ,Regimen ,Cardiovascular Diseases ,Antithrombotics ,Drug Therapy, Combination ,Coronavirus Infections ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,Factor Xa Inhibitors ,medicine.drug - Abstract
Purpose of Review Peripheral artery disease (PAD) affects an estimated 200 million people worldwide and is associated with significant cardiovascular morbidity and mortality. Cardiovascular risk is further increased among individuals with polyvascular disease, where either cerebrovascular or coronary artery disease is present in addition to PAD. In this review, we present common clinical scenarios encountered when managing patients with PAD and provide an evidence-based approach to prescribing optimal antithrombotics in this population. Recent Findings The COMPASS trial recently demonstrated that rivaroxaban 2.5 mg BID + ASA daily significantly reduces major adverse cardiac and limb events in patients with PAD. Despite these advances, morbidity following MALE events remains high. Summary With widespread approval by federal health regulators, the COMPASS regimen should be strongly considered in PAD patients who do not have a high bleeding risk. Implementing the COMPASS regimen in patients with PAD, along with other vascular risk reduction strategies, will have a substantial impact on reducing atherothromboembolic risk in patients with established vascular disease.
- Published
- 2019
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