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External applicability of the COMPASS trial: the Western Denmark Heart Registry

Editorial by Stefan Agewall published on the October Issue of European Heart Journal – Cardiovascular Pharmacotherapy

Cardiovascular Pharmacotherapy

In the COMPASS trial,(1,2) combined aspirin and rivaroxaban treatment reduced ischaemic events in patients with stable coronary artery disease (CAD) or peripheral artery disease (PAD). In the October issue of European Heart Journal – Cardiovascular Pharmacotherapy, Dr Würtz and co-workers from Denmark applied the COMPASS study criteria to patients undergoing coronary angiography (CAG) in Western Denmark (2004–2011). The authors concluded that in their broad CAG cohort, 15% were eligible for combined aspirin and rivaroxaban treatment. COMPASS-eligible patients had up to 2.5-fold higher rates of cardiovascular events than non-eligible patients. These data may indicate that this group of patients may benefit from additional preventive measures.


  1. Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, Diaz R, Alings M, Lonn EM, Anand SS, Widimsky P, Hori M, Avezum A, Piegas LS, Branch KRH, Probstfield J, Bhatt DL, Zhu J, Liang Y, Maggioni AP, Lopez-Jaramillo P, O’Donnell M, Kakkar AK, Fox KAA, Parkhomenko AN, Ertl G, Stork S, Keltai M, Ryden L, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Verhamme PB, Vinereanu D, Kim JH, Tonkin AM, Lewis BS, Felix C, Yusoff K, Steg PG, Metsarinne KP, Cook BN, Misselwitz F, Chen E, Leong D, Yusuf S. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med 2017;377:1319–1330
  2. Niessner A, Agewall S. Critical appraisal of the COMPASS trial. Eur Heart J Cardiovasc Pharmacother  2018;4:191–192.
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.