Piotr Desperak1, Bartosz Hudzik1,2, Mariusz Gąsior1. 1. 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland 2. Department of Cardiovascular Disease Prevention, Department of Metabolic Disease Prevention, School of Public Health in Bytom, Medical University of Silesia, Bytom, Poland
Abstract
INTRODUCTION: The positive outcomes of the COMPASS trial raise questions about the proportion of patients who could benefit from additional therapy with rivaroxaban in real‑world practice. OBJECTIVES: We aimed to identify the proportion of patients from the TERCET registry with significant coronary artery disease (TERCET‑CAD) who could benefit from the use of rivaroxaban and to assess their clinical characteristics and long‑term prognosis in comparison with the corresponding measures in the COMPASS trial. PATIENTS AND METHODS: The COMPASS criteria were applied in the TERCET‑CAD population. Patients who met the criteria of the COMPASS trial were included in the COMPASS‑like group. The baseline characteristics and long‑term outcomes of the COMPASS‑like group were compared with the corresponding measures in the acetylsalicylic acid (ASA)-alone arm from the COMPASS trial. RESULTS: The COMPASS‑like group included 3884 patients (31.6%) out of the 12 286 patients constituting the TERCET‑CAD population. Patients in the COMPASS‑like group were characterized by older age (P <0.001) and a more frequent occurrence of risk factors for CAD than those in the ASA‑alone arm of the COMPASS trial. The rate of a composite endpoint in the COMPASS‑like group was 9%, and in the ASA‑alone arm of the COMPASS trial, it was 6% (P <0.001). CONCLUSIONS: Less than one-third of the TERCET‑CAD population met the COMPASS criteria and could potentially benefit from low‑dose rivaroxaban therapy. Unfavorable clinical profiles and higher rates of adverse events in the TERCET registry compared with those in the COMPASS trial may predict greater benefits from the implementation of low‑dose rivaroxaban in the real‑world population.
INTRODUCTION: The positive outcomes of the COMPASS trial raise questions about the proportion of patients who could benefit from additional therapy with rivaroxaban in real‑world practice. OBJECTIVES: We aimed to identify the proportion of patients from the TERCET registry with significant coronary artery disease (TERCET‑CAD) who could benefit from the use of rivaroxaban and to assess their clinical characteristics and long‑term prognosis in comparison with the corresponding measures in the COMPASS trial. PATIENTS AND METHODS: The COMPASS criteria were applied in the TERCET‑CAD population. Patients who met the criteria of the COMPASS trial were included in the COMPASS‑like group. The baseline characteristics and long‑term outcomes of the COMPASS‑like group were compared with the corresponding measures in the acetylsalicylic acid (ASA)-alone arm from the COMPASS trial. RESULTS: The COMPASS‑like group included 3884 patients (31.6%) out of the 12 286 patients constituting the TERCET‑CAD population. Patients in the COMPASS‑like group were characterized by older age (P <0.001) and a more frequent occurrence of risk factors for CAD than those in the ASA‑alone arm of the COMPASS trial. The rate of a composite endpoint in the COMPASS‑like group was 9%, and in the ASA‑alone arm of the COMPASS trial, it was 6% (P <0.001). CONCLUSIONS: Less than one-third of the TERCET‑CAD population met the COMPASS criteria and could potentially benefit from low‑dose rivaroxaban therapy. Unfavorable clinical profiles and higher rates of adverse events in the TERCET registry compared with those in the COMPASS trial may predict greater benefits from the implementation of low‑dose rivaroxaban in the real‑world population.