Secondary prevention of ishemic stroke. Use of a combination of acetylsalicylic acid with low doses of rivaraxoban in individuals with multifocal atherosclerosis

The objective of this study was to evaluate the efficacy and safety of combined antithrombotic therapy: acetylsalicylic acid 75–100 mg once daily together with rivaroxaban 2.5 mg twice daily in patients with multifocal atherosclerosis and a history of ischemic stroke of the atherothrombotic subtype.

Materials and Methods. Two groups of patients with multifocal atherosclerosis (main group, control group) were selected, comprising 161 individuals who had suffered an ischemic stroke of the atherothrombotic subtype. The main group included 105 patients receiving acetylsalicylic acid 75–100 mg daily as secondary stroke prevention. The control group consisted of 65 patients receiving combined antithrombotic therapy – rivaroxaban 2.5 mg twice daily together with acetylsalicylic acid 75–100 mg.

Results and Conclusion. In the group of patients with atherothrombotic ischemic stroke who received dual antiplatelet therapy, a statistically significant reduction in the number of recurrent cardiovascular events was observed, compared to the main group receiving monotherapy with acetylsalicylic acid 75–100 mg (p=0.002). These data may indicate the effectiveness of using acetylsalicylic acid 75–100 mg daily together with rivaroxaban 2.5 mg twice daily and confirm the advantages of this combination over monotherapy with acetylsalicylic acid 75–100 mg for secondary prevention of cardiovascular events. The administration of rivaroxaban 2.5 mg twice daily together with acetylsalicylic acid 75–100 mg did not lead to the development of major bleeding, including bleeding requiring hospitalization or resulting in death, which may indicate the safety of this combination.

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