ArticleFrontiers in cardiovascular medicine2026
Rivaroxaban plus antiplatelet therapy for coronary artery ectasia: 36-month outcomes and risk prediction from a retrospective cohort study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Coronary artery ectasia (CAE) is characterized by abnormal coronary dilation and slow flow, predisposing patients to thrombotic complications. Optimal long-term antithrombotic strategies for CAE remain undefined. This study aimed to evaluate the efficacy and safety of low-dose rivaroxaban combined with single antiplatelet therapy in patients with CAE. Methods: In this single-center retrospective cohort study, 312 patients with CAE were enrolled and followed for 36 months. Patients received either single antiplatelet therapy alone or in combination with low-dose rivaroxaban. Propensity score matching (1:1) was performed to balance baseline characteristics. The primary endpoint was major adverse cardiovascular events (MACE). Secondary analyses included changes in thrombotic, inflammatory, and myocardial injury biomarkers. Cox proportional hazards models, inverse probability weighting, competing risk models, and sensitivity analyses were conducted to assess robustness. Results: After propensity score matching (124 vs. 124), combination therapy was associated with a significantly lower risk of 36-month MACE compared with antiplatelet therapy alone (8.1% vs. 21.8%; HR = 0.34, 95% CI: 0.19-0.62; Conclusions: In patients with CAE, low-dose rivaroxaban combined with single antiplatelet therapy was associated with lower long-term MACE risk without a significant increase in major bleeding. The benefit appeared particularly pronounced in patients with diffuse ectasia and higher thrombotic burden. The simple predictive model based on D-dimer, Markis classification, and treatment regimen may aid in individualized antithrombotic decision-making, but requires external validation.
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