Bernard Toney Jr., DMSc, PA-C
Purpose: The article aims to explore that utilization of Rivaroxaban plus Aspirin prevents more atherosclerotic cardiovascular events versus Aspirin alone.
Method: A PubMed literature search was conducted, with search terms cardiovascular events, coronary artery disease (CAD), Peripheral artery disease (PAD), Aspirin, and Rivaroxaban plus Aspirin. Few pertinent articles were retrieved and served as the basis for this clinical review.
Results: Utilization of rivaroxaban plus aspirin versus aspirin alone shows major reductions in adverse cardiovascular events including, coronary heart disease (CHD), such as myocardial infarction (MI), and angina. It also includes cerebrovascular disease, such as transient ischemic attack (TIA) and carotid artery stenosis. It also consists of peripheral artery disease (PAD), such as claudication. The benefits of dual therapy regimen outweigh the risk of bleeding.
Conclusion: Aspirin alone has been the mainstay treatment for cardiovascular (CV) risk prevention since the early 1980s. However, the utilization of aspirin alone in low-risk patients is very controversial due to the increased risk of bleeding. Despite being a cornerstone therapy, the number of CVD deaths steadily increased from 12.1 million in 1990 to 18.6 million in 2019.11 Hence, more attention has been focused on the addition of Factor Xa inhibitors like rivaroxaban with low-dose aspirin to lower the incidence of major cardiac events. Compared to the standard therapy of Aspirin alone, the addition of 5 mg low-dose Rivaroxaban to the daily regimen shows improvement in the outcomes of patients with ASCVD. Nevertheless, for dual therapy to be effective in clinical practice it must be individualized.
Patel J. Rivaroxaban plus Aspirin for Atherosclerotic Cardiovascular Disease. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(3).
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