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Polyvascular Disease – COMPASS Trial — SCE Neurology MCQ

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HardCerebrovascular DiseasePolyvascular Disease – COMPASS TrialSCE Neurology

A 60-year-old man with ischaemic stroke is discharged on aspirin 75 mg daily. He also has peripheral arterial disease and coronary artery disease. Recent trial evidence (COMPASS trial) suggests adding which medication to aspirin may further reduce cardiovascular events?

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Correct answer: E — Low-dose rivaroxaban 2.5 mg twice daily

The COMPASS trial demonstrated that adding low-dose rivaroxaban (2.5 mg twice daily) to aspirin reduced the composite of cardiovascular death, stroke, and MI in patients with stable atherosclerotic vascular disease (including PAD and CAD), compared with aspirin alone. This combination is now used in selected high-risk patients with polyvascular disease. A: Dual antiplatelet with clopidogrel long-term increases bleeding risk. C: Warfarin is for AF, not stable atherosclerosis. D: Ticagrelor is for acute coronary syndromes. E: Dipyridamole has limited evidence for PAD/CAD.

Reference: COMPASS Trial (2017); NICE NG128