Practical guidance on the use of rivaroxaban 2,5 mg twice daily in patients at high risk of atherosclerotic cardiovascular complications – perspectives from a cardiologist, a family medicine specialist, and a vascular surgeon Review article

Abstract

This article presents a multidisciplinary overview of the practical use of rivaroxaban 2.5 mg twice daily in patients at high risk of atherosclerotic cardiovascular complications. The clinical rationale for this therapy is discussed, with emphasis on evidence from the COMPASS and VOYAGER PAD trials, which demonstrated that combining rivaroxaban with acetylsalicylic acid effectively reduces myocardial infarction, stroke, and cardiovascular mortality. Patient selection criteria for chronic coronary syndrome and peripheral arterial disease are summarized, along with practical implications for cardiologists, vascular surgeons, and family medicine specialists. The article highlights the importance of early initiation of therapy, careful assessment of bleeding risk, monitoring of renal function, and patient education. Rivaroxaban 2.5 mg twice daily combined with ASA is presented as an effective, safe, and guideline-recommended long-term secondary prevention strategy for patients with multivessel atherosclerosis and PAD.