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dc.contributor.authorEikelboom, John W.
dc.contributor.authorConnolly, Stuart J.
dc.contributor.authorBosch, Jackie
dc.contributor.authorDagenais, Gilles R.
dc.contributor.authorHart, Robert G.
dc.contributor.authorShestakovska, Olga
dc.contributor.authorDiaz, Rafael
dc.contributor.authorAlings, Marco
dc.contributor.authorLonn, Eva M.
dc.contributor.authorAnand, Sonia S.
dc.contributor.authorWidimsky, Petr
dc.contributor.authorHori, Masatsugu
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorPiegas, Leopoldo S.
dc.contributor.authorBranch, Kelley R.H.
dc.contributor.authorProbstfield, Jeffrey
dc.contributor.authorBhatt, Deepak L.
dc.contributor.authorZhu, Jun
dc.contributor.authorLiang, Yan
dc.contributor.authorMaggioni, Aldo P.
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorO’Donnell, Martin
dc.contributor.authorKakkar, Ajay
dc.contributor.authorFox, Keith A.A.
dc.contributor.authorParkhomenko, Alexander N.
dc.contributor.authorErtl, Georg
dc.contributor.authorStörk, Stefan
dc.contributor.authorKeltai, Matyas
dc.contributor.authorRyden, Lars
dc.contributor.authorPogosova, Nana
dc.contributor.authorDans, Antonio L.
dc.contributor.authorLanas, Fernando
dc.contributor.authorCommerford, Patrick J.
dc.contributor.authorTorp-Pedersen, Christian
dc.contributor.authorGuzik, Tomek J.
dc.contributor.authorVerhamme, Peter B.
dc.contributor.authorVinereanu, Dragos
dc.contributor.authorKim, Jae-Hyung
dc.contributor.authorTonkin, Andrew M.
dc.contributor.authorLewis, Basil S.
dc.contributor.authorFelix, Camilo
dc.contributor.authorYusoff, Khalid
dc.contributor.authorSteg, P. Gabriel
dc.contributor.authorMetsarinne, Kaj P.
dc.contributor.authorCook Bruns, Nancy
dc.contributor.authorMisselwitz, Frank
dc.contributor.authorChen, Edmond
dc.contributor.authorLeong, Darryl
dc.contributor.authorYusuf, Salim
dc.date.accessioned2018-09-20T16:07:08Z
dc.date.available2018-09-20T16:07:08Z
dc.date.issued2017-08-27
dc.identifier.citationEikelboom, John W. Connolly, Stuart J.; Bosch, Jackie; Dagenais, Gilles R.; Hart, Robert G.; Shestakovska, Olga; Diaz, Rafael; Alings, Marco; Lonn, Eva M.; Anand, Sonia S.; Widimsky, Petr; Hori, Masatsugu; Avezum, Alvaro; Piegas, Leopoldo S.; Branch, Kelley R.H.; Probstfield, Jeffrey; Bhatt, Deepak L.; Zhu, Jun; Liang, Yan; Maggioni, Aldo P.; Lopez-Jaramillo, Patricio; O’Donnell, Martin; Kakkar, Ajay; Fox, Keith A.A.; Parkhomenko, Alexander N.; Ertl, Georg; Störk, Stefan; Keltai, Matyas; Ryden, Lars; Pogosova, Nana; Dans, Antonio L.; Lanas, Fernando; Commerford, Patrick J.; Torp-Pedersen, Christian; Guzik, Tomek J.; Verhamme, Peter B.; Vinereanu, Dragos; Kim, Jae-Hyung; Tonkin, Andrew M.; Lewis, Basil S.; Felix, Camilo; Yusoff, Khalid; Steg, P. Gabriel; Metsarinne, Kaj P.; Cook Bruns, Nancy; Misselwitz, Frank; Chen, Edmond; Leong, Darryl; Yusuf, Salim (2017). Rivaroxaban with or without aspirin in stable cardiovascular disease. New England Journal of Medicine 377 (14), 1319-1330
dc.identifier.issn0028-4793,1533-4406
dc.identifier.urihttp://hdl.handle.net/10379/11337
dc.description.abstractBACKGROUND We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P< 0.001; z = -4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P< 0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P = 0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban- alone group. CONCLUSIONS Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events.
dc.publisherNew England Journal of Medicine (NEJM/MMS)
dc.relation.ispartofNew England Journal of Medicine
dc.subjectatherothrombotic events
dc.subjectvenous thromboembolism
dc.subjectsecondary prevention
dc.subjectoral rivaroxaban
dc.subjecttrial
dc.subjectclopidogrel
dc.subjectrisk
dc.titleRivaroxaban with or without aspirin in stable cardiovascular disease
dc.typeArticle
dc.identifier.doi10.1056/nejmoa1709118
dc.local.publishedsourcehttp://discovery.ucl.ac.uk/10050927/1/nejmoa1709118.pdf
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