Bolognese Leonardo, Felici Massimo
Dipartimento Cardio-neuro-vascolare, Azienda Sudest Toscana,Italy.
Eur Heart J Suppl. 2020 Nov 18;22(Suppl L):L24-L27. doi: 10.1093/eurheartj/suaa128. eCollection 2020 Nov.
Patients with established cardiovascular (CV) disease may suffer further CV events, despite receiving optimal medical treatment. Although platelet inhibition plays a central role in the prevention of new events, the use of anticoagulant therapies to reduce events in atheromatous disease has, until recently, been overlooked. The recent Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS) trial showed that rivaroxaban 2.5 mg twice daily given with low-dose aspirin reduces the incidence of the composite endpoint of stroke, heart attack, and death in patients with stable coronary artery disease. Although there are some limitations to the study, COMPASS offers promising conclusions and may change secondary prevention in patients with stable CV disease. This article reviews the results of the COMPASS study and how these results may affect patient management in everyday clinical practice.
尽管接受了最佳药物治疗，但已确诊心血管疾病（CV）的患者仍可能发生进一步的心血管事件。虽然血小板抑制在预防新事件中起着核心作用，但直到最近，使用抗凝疗法来减少动脉粥样硬化疾病中的事件一直被忽视。最近的用于预防冠状动脉或外周动脉疾病主要心血管事件的利伐沙班（COMPASS）试验表明，每日两次服用2.5毫克利伐沙班并联合低剂量阿司匹林可降低稳定型冠状动脉疾病患者中风、心脏病发作和死亡的复合终点发生率。尽管该研究存在一些局限性，但COMPASS提供了有前景的结论，可能会改变稳定型心血管疾病患者的二级预防。本文综述了COMPASS研究的结果以及这些结果可能如何影响日常临床实践中的患者管理。
