CLINICAL PERFORMANCE AND PERSISTENCE ON DUAL PATHWAY INHIBITION WITH RIVAROXABAN AND ASPIRIN IN REAL-WORLD SETTING.

Abstract

The dual pathway inhibition (DPI) with low dose rivaroxaban and aspirin in patients with stable atherosclerotic vascular disease reduced the occurrence of cardiovascular (CV) events, with no significant increase of intracranial or other critical organ bleedings. Our observational study aimed to describe the clinical performance, adherence and persistence of DPI therapy among a real-world setting of patients with an established diagnosis of coronary artery (CAD) and/or peripheral artery disease (PAD). We prospectively included all consecutive patients with an established diagnosis of CAD and/or PAD treated with aspirin (ASA) 100 mg once daily (OD) and rivaroxaban 2.5 mg twice daily (TD). Clinical evaluation was carried out at baseline, before starting treatment, at 1 month, and every 6 months after the study drug administration. 202 consecutive patients (mean age 66 ± 10 years; male 80%) eligible to DPI therapy were included. During a mean follow-up of 664 ± 177 days, the incidence rate of major bleedings and of major cardiovascular events (MACE) was 0.8 and 1.1 per 100 patients/year, respectively. The adherence to pharmacological treatment was 99%.Additionally, 13.4% of patients have suspended the DPI therapy during the follow-up.Minor bleedings resulted the most common cause of both temporary and permanent DPI therapy discontinuation. This observational study supports the safety of dual pathway inhibition with low-dose rivaroxaban and aspirin among patients with CAD and PAD in a real-world setting, showing high persistence and maximum adherence to medical treatment.