Ferreira JP, Lam CSP, Anker SD, et al. - In patients registered in the COMMANDER‐HF trial who were in sinus rhythm, had heart failure with reduced ejection fraction and coronary artery disease, researchers explored the connection between D‐dimer levels and the risk of stroke and other thrombotic, bleeding and fatal events, and if D‐dimer concentrations could predict the effect of rivaroxaban 2.5 mg twice daily (vs placebo). Baseline measurement of D‐dimer was available in 4,107 (82%) of 5,022 patients registered. Higher plasma D‐dimer concentrations were independently linked to higher rates of death, stroke, and venous thromboembolism. Rivaroxaban decreased the risk of stroke in COMMANDER‐HF participants, but the benefit may be restricted to patients with D‐dimer concentrations over 515 ng/mL. Prospective trials to validate these results are warranted. In each tertile of D‐dimer, the impact of rivaroxaban was comparable for all outcomes except stroke. Patients within the highest tertile had the largest absolute and relative stroke reduction.