Sharma M, et al. - Researchers performed detailed analyses of stroke by type, predictors, and antithrombotic effects in key subgroups among participants of the COMPASS Trial, which demonstrated a significant reduction in strokes with the combination of rivaroxaban plus aspirin vs aspirin. Subjects with stable coronary artery or peripheral artery disease were included; those requiring anticoagulation, stroke within 1 month, previous lacunar stroke, or intracerebral hemorrhage were excluded. They found that, in the rivaroxaban plus aspirin group vs in the aspirin group, strokes occurred in fewer patients. In the rivaroxaban alone group vs aspirin, the occurrence of stroke was not significantly different. The combination resulted in decreased occurrence of fatal and disabling stroke. The strongest predictor of incident stroke was prior stroke, which was also related to a 3.4% per year rate of stroke recurrence on aspirin. Across subgroups with high stroke risk, including those with prior stroke, a consistent effect of the combination vs aspirin was evident.