I have just returned from the European Society of Cardiology meeting 2018 in Munich Germany and found it very useful. There are some very interesting studies and findings, which I hope to share with you in the next few months.


I had several specific topics I focused upon, my subspecialty field of coronary intervention and stent insertion being primary, but also general topics such as hypertension (high blood pressure), heart failure, cardio-oncology and arrhythmia amongst others.

Today, I would like to share some findings of an important study published in 2017 and hotly discussed and debated at the ESC meeting this year.



The COMPASS trial was published in the New England Journal of Medicine (NEJM) in October 2017 (NEJM 2017; 377:1319-1330; DOI: 10.1056/NEJMoa1709118).

The study assessed a specific medication regime for patients with stable angina (ischaemic heart disease). Some specific subgroups of patients were excluded and for all details please see the original paper.

However, some important exclusions were patients needing dual anti-platelet therapy, such as patients having had a recent stent insertion/PCI. Another excluded group were patients with recent strokes or patients needing higher doses of Rivaroxaban (or similar drugs), such as patients with Atrial fibrillation.

Read more about Atrial fibrillation

The Findings

The overall finding, however, was that the combination of Aspirin and low dose Rivaroxaban was superior to Aspirin alone.

Superiority was achieved for the primary outcome, which was a composite of cardiovascular death, stroke, or myocardial infarction.

This trial has very important implications for our current management of stable angina patients.

The current guidelines, however, recommend treating stable angina patients with Aspirin alone. 

The take-away message of COMPASS is that the combination of Aspirin and Rivaroxaban is clearly superior and should now be considered gold standard for this patient subset. 

In fact, the results of the COMPASS trial were so convincing that the trial committee and researchers involved stopped the trial early, in order to allow all patients to benefit from the combination therapy of Aspirin and Rivaroxaban.

Cardiologist Kent

If you have been experiencing unusual heart and chest symptoms, put your mind at ease by seeking the help you deserve, or book for a heart screening test so you can actively work to prevent heart conditions in the future.

If you wish to discuss this further please book an appointment.

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