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

Authors
  • Würtz, Morten1, 2
  • Olesen, Kevin Kris Warnakula1, 3
  • Thim, Troels1
  • Kristensen, Steen Dalby1, 4
  • Eikelboom, John W5
  • Maeng, Michael1
  • 1 Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK Aarhus, Denmark. , (Denmark)
  • 2 Department of Cardiology, Regional Hospital West Jutland, Gl. Landevej 61, DK Herning, Denmark. , (Denmark)
  • 3 Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK Aarhus, Denmark. , (Denmark)
  • 4 Department of Clinical Medicine, Faculty of Health, Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, DK Aarhus, Denmark. , (Denmark)
  • 5 Population Health Research Institute, Hamilton Health Sciences, McMaster University, 237 Barton Street East, Ontario, Canada. , (Canada)
Type
Published Article
Journal
European heart journal. Cardiovascular pharmacotherapy
Publication Date
Oct 01, 2019
Volume
5
Issue
4
Pages
192–199
Identifiers
DOI: 10.1093/ehjcvp/pvz013
PMID: 30916315
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In the COMPASS trial, combined aspirin and rivaroxaban treatment reduced ischaemic events in patients with stable coronary artery disease (CAD) or peripheral artery disease (PAD). We estimated the proportion of COMPASS eligible patients among unselected patients undergoing coronary angiography (CAG) and compared outcome rates among COMPASS eligible and non-eligible patients. We applied the COMPASS study criteria on patients undergoing CAG in Western Denmark (2004-11). Both COMPASS eligible and non-eligible patients had CAD/PAD and met no exclusion criteria, but only COMPASS eligible patients met the inclusion criteria. We assessed the COMPASS primary endpoint of cardiovascular death, ischaemic stroke, haemorrhagic stroke, or myocardial infarction (MI). We computed event rates and adjusted incidence rate ratios (aIRRs). Of 80 071 patients undergoing CAG, 27 939 did not have CAD or PAD and were not considered. Of the 52 132 patients remaining, 11 930 were COMPASS eligible. Rates of the primary endpoint were 4.8 (95% confidence interval 4.6-5.0) events per 100 person-years among COMPASS eligible patients and 2.3 (2.2-2.4) among COMPASS non-eligible patients [aIRR 1.7 (1.6-1.9)]. COMPASS eligible patients also had higher risks of cardiovascular death [aIRR 2.5 (2.1-3.0)], ischaemic stroke [aIRR 1.4 (1.2-1.6)], and MI [aIRR 1.9 (1.7-2.1)]. In this all-comers 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. The higher incidence of ischaemic events in COMPASS eligible patients highlights an unmet need for additional preventive measures. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: [email protected]

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