Clinical characteristics and outcomes of COMPASS eligible patients in France. An analysis from the REACH Registry

Following the publication of the COMPASS trial, the European Medicines Agency has approved a regimen of combination of rivaroxaban 2.5mg twice daily and a daily dose of 75–100mg acetylsalicylic acid (ASA) for patients with coronary artery disease (CAD) or symptomatic peripheral artery disease (PAD)...

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Published in:Annales de cardiologie et d'angéiologie 2020-10, Vol.69 (4), p.158-166
Main Authors: Darmon, A., Elbez, Y., Bhatt, D.L., Abtan, J., Mas, J.L., Cacoub, P., Montalescot, G., Billaut-Laden, I., Ducrocq, G., Steg, P.G.
Format: Article
Language:English
Subjects:
Applicabilité externe
COMPASS trial
Coronary artery disease
Essai COMPASS
External applicability
Life Sciences
Maladie artérielle périphérique
Maladie coronaire
Peripheral arterial disease
rivaroxaban
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Summary:Following the publication of the COMPASS trial, the European Medicines Agency has approved a regimen of combination of rivaroxaban 2.5mg twice daily and a daily dose of 75–100mg acetylsalicylic acid (ASA) for patients with coronary artery disease (CAD) or symptomatic peripheral artery disease (PAD) at high risk of ischemic events. However, the applicability of such a therapeutic strategy in France is currently unknown. To describe the proportion of patients eligible to COMPASS in France, their baseline clinical characteristics and the rate of major adverse cardiovascular events, using the REACH registry. From the the REduction of Atherothrombosis for Continued Health (REACH) registry database, a large international registry of patients with, or at risk, of atherothrombosis, we analyzed patients included in France with either established CAD and/or PAD and fulfilling the inclusion and exclusion criteria of the COMPASS trial. The ischemic outcome was a composite of cardiovascular (CV) death, myocardial infarction (MI), or stroke, and serious bleeding were defined as haemorrhagic stroke or bleeding leading to hospitalization or transfusion. Among more than 65000 patients enrolled in REACH, 2.012 patients were evaluable and enrolled in France. Among them, 1194 patients (59.3%) were eligible to COMPASS. The main reasons for exclusion of the COMPASS trial, were high bleeding risk (59.1%), anticoagulant use (43.4%), requirement for dual antiplatelet therapy within 1 year of an ACS or PCI (24.7%). In the “COMPASS eligible population”, the rate of MACE (CV, MI and stroke) at 4 years follow-up was 13.4% [11.3–15.8], and serious bleeding was 2.5% at 4 years [1.6–3.4]. Patients with polyvascular disease (n=219) had the highest rate of MACE, compared with patients with CAD only and PAD only (19.1% [13.9–26.1] vs. 11.6% [9.1–14.8] vs 13.2% [9.2–18.8], P
ISSN:0003-3928
1768-3181
DOI:10.1016/j.ancard.2020.07.002