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Use of risk scores to identify lower and higher risk subsets among COMPASS‐eligible patients with chronic coronary syndromes: Insights from the CLARIFY registry

Clinical Cardiology Dec 26, 2020

Darmon A, Ducrocq G, Jasilek A, et al. - By utilizing data from a large international registry (CLARIFY Registry) comprising more than 30,000 patients with chronic coronary syndromes (CCS), researchers assessed the performance of ischemic and bleeding risk scores: the CHA2DS2VaSc score, the REACH Recurrent Ischemic Score (RIS) and the REACH Bleeding Risk Score (BRS) in order to attempt to detect patients with the most favorable trade‐off between ischemic and bleeding events, in CCS patients eligible to COMPASS. In the COMPASS trial, low‐dose rivaroxaban and aspirin vs aspirin alone was shown to confer a decrease of ischemic events in CCS at the expense of increased bleeding. Higher ischemic risk was observed in patients with intermediate REACH RIS with similar bleeding risk as the overall population. A very low ischemic risk with similar bleeding risk was noted in patients with low CHA2DS2VaSc. Overall, potential optimal candidates for adjunction of low‐dose rivaroxaban were revealed by intermediate REACH RIS while benefit from the COMPASS regimen seemed unlikely in patients with low CHA2DS2VaSc score. The occurrence of serious bleeding was not predicted by any of the three risk scores.

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