Branch KR, et al. - Given that a high risk for major adverse cardiovascular events (MACE) exists in patients with chronic coronary artery disease (CAD) or peripheral artery disease (PAD) and history of heart failure (HF), researchers determined the impacts of rivaroxaban with or without aspirin in these patients. In a randomized manner, rivaroxaban 2.5 mg twice daily plus aspirin 100 mg daily, rivaroxaban 5 mg twice daily alone, or aspirin 100 mg alone was administered to 27,395 participants with chronic CAD or PAD in the COMPASS trial. This study did not include patients with NYHA class III or IV HF or left ventricular ejection fraction <30%. Cardiovascular mortality, stroke, or myocardial infarction was the primary MACE outcome. Major bleeding using modified ISTH criteria was the primary safety outcome. Similar relative but larger absolute benefits were provided by combination rivaroxaban and aspirin vs aspirin alone in patients with chronic CAD or PAD and a history of mild or moderate HF vs those without HF in this study.