The rivaroxaban plus aspirin combination therapy to treat patients with stable coronary or peripheral artery disease showed such benefits in the COMPASS trial that it should become the standard of care, said John Eikelboom, MBBS, MSc, FRCPC, associate professor at McMaster University.

How will COMPASS change the standard of care for patients with coronary artery disease and peripheral artery disease?
I think the COMPASS trial results have the potential to change the way we manage people with stable coronary or peripheral artery disease. It's important to remember that the benefits of the combination (rivaroxaban + aspirin) treatment compared with aspirin alone were achieved in people already well treated with lipid-lowering, blood pressure–lowering, and angiotensin converting enzyme (ACE) therapy.

We've shown that the results were consistent in those with the lowest blood pressure, the lowest cholesterol level, and non-smokers. And the magnitude of the benefit is, in fact, as large, or larger, than the effect of lipid-lowering, the effect of blood pressure–lowering, and the use of ACE inhibition. So we're adding on top of existing treatments with a similar, additional benefit.

That is why I think—it needs to go through regulatory and payer evaluation—but, eventually, I think it will become the standard of care for antithrombotic protection in the long term.

Learn more about the COMPASS results with the study write-up and an interview with Deepak Bhatt, MD, MPH, of Brigham & Women's Hospital and Harvard Medical School.