In patients with established stable atherosclerotic disease, rivaroxaban plus aspirin resulted in a modest 1.3% absolute risk reduction in cardiovascular death, stroke, or nonfatal MI, with a trend toward improved mortality. This benefit was offset by a 1.2% increased absolute risk in major bleeding.

For patients with increased thrombotic risk that outweighs bleeding risk, then low-dose rivaroxaban BID + ECASA 100 daily is a reasonable treatment strategy.

---