Are COMPASS Candidates Among Internal Medicine Patients? Insights from the Internal Medicine Clinic
DOI:
https://doi.org/10.24950/rspmi.2176Keywords:
Aspirin/therapeutic use, Coronary Artery Disease/ drug therapy, Peripheral Arterial Disease/drug therapy, Rivaroxaban/therapeutic useAbstract
Introduction: We sought to evaluate if internal medicine
outpatients are candidates to COMPASS trial strategy (low
dose rivaroxaban twice a day plus daily acetylsalicylic acid),
to detail the inclusion and exclusion criteria of COMPASS trial presented by internal medicine patients and to evaluate the frequency of patients already under the strategy.
Methods: Observational, retrospective, and transversal
study in an internal medicine department of a tertiary university hospital. During a one-month period, we consulted all electronic medical records of internal medicine appointments to assess which patients presented inclusion and exclusion criteria of the COMPASS trial.
Results: Of 228 patients, 40 (17.5%) met inclusion criteria
for COMPASS trial. Twelve (30.0%) had coronary artery disease, 21 (52.5%) had peripheral artery disease, and 6 (1.5%) had both. One patient was already on the COMPASS trial strategy. Of those who met inclusion criteria, 70.0% (n = 28) presented at least one exclusion criteria. The most frequent was the use of oral anticoagulation (mostly due to atrial fibrillation), followed by the users of non- acetylsalicylic acid antiplatelet therapy.
Conclusion: The number of internal medicine patients who are eligible to benefit from the COMPASS strategy is relevant. Internal medicine physicians must be aware of inclusion and exclusion criteria of this new prevention strategy to promptly apply it in clinical practice.
Downloads
References
Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, et al. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017;377:1319-30. doi: 10.1056/NEJMoa1709118.
Steffel J, Eikelboom JW, Anand SS, Shestakovska O, Yusuf S, Fox KAA. The COMPASS Trial: net clinical benefit of low-dose rivaroxaban plus aspirin as compared with aspirin in patients with chronic vascular disease. Circulation. 2020;142:40-8. doi: 10.1161/CIRCULATIONAHA.120.046048.
Walley T. Therapeutic conservatism. J R Coll Physicians Lond.1993;27:198-9.
Lapostolle F, Petrovic T, Goix L, Adnet F. Impact of COVID-19 pandemic on non-COVID-19 publications. Resuscitation. 2021;162:102-3. doi: 10.1016/j.resuscitation.2021.02.020.
Polidori MC, Alves M, Bahat G, Boureau AS, Ozkok S, Pfister R, Pilotto A, et al. Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines. Eur Geriatr Med. 2022;13:5-18. doi: 10.1007/S41999-021-00537-W
Darmon A, Bhatt DL, Elbez Y, Aboyans V, Anand S, Bosch J, et al. External applicability of the COMPASS trial: an analysis of the reduction of atherothrombosis for continued health (REACH) registry. Eur Heart J. 2018;39(9):750-7a. doi: 10.1093/EURHEARTJ/EHX658
De Luca L, Formigli D, Meessen J, Uguccioni M, Cosentino N, Paolillo C, et al. COMPASS criteria applied to a contemporary cohort of unselected patients with stable coronary artery diseases: insights from the START registry. Eur Heart J Qual Care Clin Outcomes. 2021;7:513-20. doi: 10.1093/EHJQCCO/QCAA054
Lapébie FX, Aboyans V, Lacroix P, Constans J, Boulon C, Messas E, et al. Editor’s Choice – External Applicability of the COMPASS and VOYAGER-PAD Trials on Patients with Symptomatic Lower Extremity Artery Disease in France: The COPART Registry. Eur J Vasc Endovasc Surg. 2021;62:439-49. doi: 10.1016/J.EJVS.2021.05.028
Faria D, Santos M, Baptista SB, Ferreira J, Leal P, Abreu PF, et al. Eligibility for extended antithrombotic therapy for secondary prevention of acute coronary syndrome. Rev Port Cardiol. 2020;39:493-501. doi: 10.1016/j.repc.2020.02.012.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Internal Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
