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Volume 13
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10.3390/jcm13071956
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Article

The Net Clinical Outcome of Dual-Pathway Inhibition in Clinical Practice: The “Xarelto plus Acetylsalicylic Acid: Treatment Patterns and Outcomes in Patients with Atherosclerosis” Registry

by
Alexander Breitenstein
1,2,
Alain Gay
3,
Kai Vogtländer
4,
Keith A. A. Fox
5 and
Jan Steffel
2,* on behalf of the XATOA Publication Committee
1
Department of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland
2
University of Zurich, 8006 Zurich, Switzerland
3
Bayer AG, 13342 Berlin, Germany
4
Bayer AG, 42096 Wuppertal, Germany
5
Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH16 4TJ, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(7), 1956; https://doi.org/10.3390/jcm13071956
Submission received: 22 February 2024 / Revised: 17 March 2024 / Accepted: 22 March 2024 / Published: 28 March 2024
(This article belongs to the Section Cardiovascular Medicine)
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Abstract

Background: In the COMPASS trial, the combination of acetylsalicylic acid (ASA) plus 2.5 mg rivaroxaban twice daily (dual-pathway inhibition, DPI) has been shown to be superior to ASA monotherapy for the reduction in ischemic major adverse cardiovascular events (MACEs, i.e., cardiovascular death, stroke, or myocardial infarction). Methods: The international XATOA registry (Xarelto plus Acetylsalicylic acid: Treatment patterns and Outcomes in patients with Atherosclerosis) is a prospective post-approval registry that investigates the cardiovascular outcomes of patients taking ASA plus 2.5 mg rivaroxaban. The aim of this pre-specified analysis was to determine the net clinical outcome (NCO), i.e., a combination of MACEs and bleeding events, of DPI in patients from daily clinical practice. Results: Among the 5615 patients, the presence of multiple risk factors resulted in an increase in the total risk of experiencing an NCO event, e.g., from 1.27% (one risk factor) to 2.18% (two risk factors) and 4.07% (three or more risk factors), respectively, with ischemic MACE representing the primary driver of bleeding complications. Conclusions: In the real-world XATOA registry, the annual rate of NCO events was low and numerically similar to those seen in the treatment group in the randomized COMPASS trial.
Keywords: dual-pathway inhibition; XATOA registry; net clinical benefit dual-pathway inhibition; XATOA registry; net clinical benefit

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MDPI and ACS Style

Breitenstein, A.; Gay, A.; Vogtländer, K.; Fox, K.A.A.; Steffel, J., on behalf of the XATOA Publication Committee. The Net Clinical Outcome of Dual-Pathway Inhibition in Clinical Practice: The “Xarelto plus Acetylsalicylic Acid: Treatment Patterns and Outcomes in Patients with Atherosclerosis” Registry. J. Clin. Med. 2024, 13, 1956. https://doi.org/10.3390/jcm13071956

AMA Style

Breitenstein A, Gay A, Vogtländer K, Fox KAA, Steffel J on behalf of the XATOA Publication Committee. The Net Clinical Outcome of Dual-Pathway Inhibition in Clinical Practice: The “Xarelto plus Acetylsalicylic Acid: Treatment Patterns and Outcomes in Patients with Atherosclerosis” Registry. Journal of Clinical Medicine. 2024; 13(7):1956. https://doi.org/10.3390/jcm13071956

Chicago/Turabian Style

Breitenstein, Alexander, Alain Gay, Kai Vogtländer, Keith A. A. Fox, and Jan Steffel on behalf of the XATOA Publication Committee. 2024. "The Net Clinical Outcome of Dual-Pathway Inhibition in Clinical Practice: The “Xarelto plus Acetylsalicylic Acid: Treatment Patterns and Outcomes in Patients with Atherosclerosis” Registry" Journal of Clinical Medicine 13, no. 7: 1956. https://doi.org/10.3390/jcm13071956

APA Style

Breitenstein, A., Gay, A., Vogtländer, K., Fox, K. A. A., & Steffel, J., on behalf of the XATOA Publication Committee. (2024). The Net Clinical Outcome of Dual-Pathway Inhibition in Clinical Practice: The “Xarelto plus Acetylsalicylic Acid: Treatment Patterns and Outcomes in Patients with Atherosclerosis” Registry. Journal of Clinical Medicine, 13(7), 1956. https://doi.org/10.3390/jcm13071956

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