Coronary disease & ACSSecondary analysis
Rivaroxaban Plus Aspirin Versus Aspirin Alone in Patients With Prior Percutaneous Coronary Intervention (COMPASS-PCI)
- Secondary analysis of the COMPASS randomised trial
- prespecified subgroup analysis
- Follow-up 1.98 (SD 0.72) years
Authors' conclusion
DPI compared with aspirin produced consistent reductions in MACE and mortality but with increased major bleeding with or without previous PCI. Among those with previous PCI 1 year and beyond, the effects on MACE and mortality were consistent irrespective of time since last PCI.
Study context
- Population
- Patients with chronic coronary syndrome with or without previous percutaneous coronary intervention (PCI) in COMPASS9,862 (59.6%) previous PCI
- Participants
- 16,560 patients
- Comparison
- Dual pathway inhibition (DPI) vs aspirin 100 mg once daily, by previous PCI
- Primary endpoint
- MACE:
- CV death
- MI
- Stroke
Primary result
As reported in the abstract
MACE, by previous PCI (subgroup)
DPI vs AspirinHazard ratio (95% CI)
PCI: 4.0% vs 5.5%
0.74(0.61–0.88)
no PCI: 4.4% vs 5.7%
0.76(0.61–0.94)
Further findings
| Outcome | DPI | Aspirin | HR (95% CI) | |
|---|---|---|---|---|
| Mortality, by previous PCI (subgroup) · PCI | 2.5% | 3.5% | 0.73 (0.58–0.92) | |
| Mortality, by previous PCI (subgroup) · no PCI | 4.1% | 5.0% | 0.80 (0.64–1.00) | |
| 0.512Hazard ratio (log scale) |
- Mortality, by previous PCI (subgroup): P-interaction=0.59
Major adverse cardiovascular event (MACE) by time since previous PCI and by previous MI (previous PCI)
- Consistent reductions in MACE irrespective of time since previous PCI (1 to 10 years)
- P for interaction = 0.65
- Consistent irrespective of previous MI
- P for interaction = 0.64
Safety
| Outcome | DPI | Aspirin | HR (95% CI) | |
|---|---|---|---|---|
| Major bleeding, by previous PCI (subgroup) · PCI | 3.3% | 2.0% | 1.72 (1.34–2.21) | |
| Major bleeding, by previous PCI (subgroup) · no PCI | 2.9% | 1.8% | 1.58 (1.15–2.17) | |
| 0.512Hazard ratio (log scale) |
- Major bleeding, by previous PCI (subgroup): P-interaction=0.68
Original publication
Rivaroxaban Plus Aspirin Versus Aspirin Alone in Patients With Prior Percutaneous Coronary Intervention (COMPASS-PCI). Circulation. Published 17 March 2020. doi:10.1161/circulationaha.119.044598
Summarised from the published abstract; every number is checked against it