The prestigious New England Journal of Medicine recently published the results of the COMPASS trial.
27,000 People with pre-existing heart disease such as coronary artery disease or peripheral arterial disease were studied for over 3 years.
One group received aspirin only, the other group received a new blood thinner called Rivaroxaban only, and a third group received both aspirin and Rivaroxaban to prevent the recurrence of heart attack, stroke, or death due to heart disease.
Patients that received both aspirin and Rivaroxaban had statistically significant reduction in death and repeat heart attacks.
It is really shocking that 21% of patients with pre-existing documented heart disease or prior heart attack still continued to smoke in this study. We know that stopping smoking reduces risk of death by almost 36%.
While COMPASS trial result sounds promising for patients with stable coronary artery disease, it is worth remembering that preventing the onset of heart disease gives much more bang for the buck.
The absolute risk reduction with this combination treatment was only 1.3%. This means that we would need to treat 75 patients with stable coronary artery disease to help one patient.
Lifestyle medicine can help prevent heart disease and can also reduce the risk of recurrence of heart attacks.
It is certainly cheaper and safer.