And yet aspirin again

It is still too early to send aspirin out behind of shelves modern antiaggregation and anticoagulation medications (video with English remarks but in Russian).

Rivaroxaban Versus Aspirin

Rivaroxaban Versus Aspirin in Secondary Prevention of Stroke and Prevention of Systemic Embolism in Patients With Recent Embolic Stroke of Undetermined Source (ESUS) (NAVIGATE ESUS)

  • The decision to terminate the study due to no efficacy improvement over aspirin at an interim analysis and very little chance of showing overall benefit if the study would have been completed.
  • In an “unfortunately negative trial,” the factor Xa inhibitor rivaroxaban was not superior to aspirin in preventing recurrent stroke after a first embolic stroke of the undetermined source but was associated with a significant increase in bleeding events.

Rivaroxaban + Aspirin

Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS)

  • Combining rivaroxaban with aspirin cuts the ischemic stroke rate by almost half without significantly increasing the risk for intracerebral hemorrhage compared with aspirin alone in patients with stable atherosclerotic vascular disease.

Ticagrelor + Aspirin

  • Ticagrelor is an antagonist of the P2Y12 receptor.
  • The drug was approved for use in the European Union by the European Commission on December 3, 2010.
  • The drug was approved by the US Food and Drug Administration on July 20, 2011.
  • Ticagrelor is used for the prevention of thrombotic events (for example stroke or heart attack) in people with acute coronary syndrome or myocardial infarction with ST elevation.
  • The drug is combined with acetylsalicylic acid unless the latter is contraindicated.

Ticagrelor Versus Aspirin

Study Comparing Ticagrelor With Aspirin for Prevention of Vascular Events in Patients Undergoing CABG (TiCAB)

  • Monotherapy with a platelet aggregation inhibitor ticagrelor produced by AstraZeneca has no benefit before aspirin and has similar to the last the bleedings risk.
  • Results were shown in patients after coronary artery bypass grafting, but in accordance with the Principle of symmetry, we can expect them in everyone with clinical atherosclerosis who take ticagrelor and similar antiplatelet medications.

And yet aspirin again

Aspirin for all!

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