{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T21:55:01Z","timestamp":1788990901328,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,12,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial decreased major adverse cardiovascular events with very low\u2010dose rivaroxaban and aspirin in patients with coronary artery disease and peripheral artery disease. We examined the eligibility and potential real\u2010world impact of this strategy on the COMPASS\u2010eligible population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">COMPASS eligibility criteria were applied to the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) registry, a population\u2010based cohort of Ontario adults. We compared 5\u2010year major adverse cardiovascular events\u00a0and major bleeding rates stratified by COMPASS eligibility and by clinical risk factors. We applied COMPASS trial rivaroxaban\/aspirin arm hazard ratios to estimate the potential impact on the COMPASS\u2010eligible cohort. Among 362\u2009797 patients with coronary artery disease or peripheral artery disease, 38% were deemed eligible, 47% ineligible, and 15% indeterminate. Among eligible patients, a greater number of risk factors was associated with higher rates of cardiovascular outcomes, whereas bleeding rates increased minimally. Over 5\u2009years, applying COMPASS treatment effects to eligible patients resulted in a 2.4% absolute risk reduction of major adverse cardiovascular events and a number needed to treat of 42, and a 1.3% absolute risk increase of major bleeding and number needed to harm (NNH) of 77. Those with at least 2 risk factors had a 3.0% absolute risk reduction of major adverse cardiovascular events (number needed to treat =34) and a 1.6% absolute risk increase of major bleeding (number needed to harm =61).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Implementation of very\u2010low\u2010dose rivaroxaban therapy would potentially impact\n              <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                <mml:semantics>\n                  <mml:mrow>\n                    <mml:mo>\u2248<\/mml:mo>\n                  <\/mml:mrow>\n                  <mml:annotation encoding=\"application\/x-tex\">$$ \\approx $$<\/mml:annotation>\n                <\/mml:semantics>\n              <\/mml:math>\n              2 in 5 patients with atherosclerotic disease in Ontario. Eligible individuals with\n              <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" overflow=\"scroll\">\n                <mml:semantics>\n                  <mml:mrow>\n                    <mml:mo>\u2265<\/mml:mo>\n                  <\/mml:mrow>\n                  <mml:annotation encoding=\"application\/x-tex\">$$ \\ge $$<\/mml:annotation>\n                <\/mml:semantics>\n              <\/mml:math>\n              2 comorbidities represent a high\u2010risk subgroup that may derive the greatest benefit\u2010to\u2010risk ratio. Selection of patients with high\u2010risk predisposing factors appears appropriate in routine practice.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026553","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T11:38:34Z","timestamp":1671017914000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Eligibility and Implementation of Rivaroxaban for Secondary Prevention of Atherothrombosis in Clinical Practice\u2014Insights From the CANHEART Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1639-4879","authenticated-orcid":false,"given":"Maya S.","family":"Sheth","sequence":"first","affiliation":[{"name":"Women\u2019s College Research Institute Toronto Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yu","sequence":"additional","affiliation":[{"name":"ICES Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4614-7684","authenticated-orcid":false,"given":"Anna","family":"Chu","sequence":"additional","affiliation":[{"name":"ICES Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Porter","sequence":"additional","affiliation":[{"name":"ICES Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick Y","family":"Tam","sequence":"additional","affiliation":[{"name":"ICES Toronto Canada"},{"name":"Schulich Heart Centre, Sunnybrook Health Sciences Centre Toronto Canada"},{"name":"Institute of Health Policy, Management, and Evaluation University of Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2911-6341","authenticated-orcid":false,"given":"Laura E.","family":"Ferreira\u2010Legere","sequence":"additional","affiliation":[{"name":"ICES Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8068-2440","authenticated-orcid":false,"given":"Shaun G.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Applied Health Research Centre, Li Ka Shing Knowledge Institute St Michael\u2019s Hospital Toronto Canada"},{"name":"Department of Medicine, Faculty of Medicine University of Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Farkouh","sequence":"additional","affiliation":[{"name":"Applied Health Research Centre, Li Ka Shing Knowledge Institute St Michael\u2019s Hospital Toronto Canada"},{"name":"Department of Medicine, Faculty of Medicine University of Toronto 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Canadian Drug Expert Committee Recommendation: Rivaroxaban (Xarelto \u2014 Bayer Inc.): indication: coronary artery disease with or without peripheral artery disease. In 2018 [cited 2020 Sept 3]. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK541456\/"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/biom.13009"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.122.026553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:37:50Z","timestamp":1715603870000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.122.026553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,20]]},"references-count":25,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2022,12,20]]}},"alternative-id":["10.1161\/JAHA.122.026553"],"URL":"https:\/\/doi.org\/10.1161\/jaha.122.026553","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,20]]},"assertion":[{"value":"2022-06-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e026553"}}