Bendary etal.The Egyptian Heart Joumal (2023)75:40The Egyptian Hearthttp5/doi.org/10.1186s43044-023-00364-3JournalCOMMENTARYOpen AccessBoosting protection for patientswith non-acute cardiovascular disease:a focuson antithrombotic regimen (a consensus expertopinion from the Egyptian Society of Cardiologyworking group of thrombosis and prevention)Ahmed Bendary,Bassem Zarif?,Hala Mahfouz Badran3,Khaled Shokry and Hamza KabilsAbstractBackground Till the moment of this document writing,no Egyptian consensus is there to guide selection of addi-tional antithrombotic in stable patients with established CVD.Despite use of lifestyle measures and statins,thosepatients with established CVD still face a considerable burden of residual risk.Main body With the evolvement of evidence-based medicine,there have been a lot of recommendations to useadditional antithrombotic medications to maximize protection for those patients.Accordingly,the Egyptian Society ofCardiology working group of thrombosis and prevention took the responsibility of providing an expert consensus onthe current recommendations for using antithrombotic medications to maximize protection in stable patients withestablished CVD.For stable patients with established CVD,in addition to proper lifestyle measures and appropriatedose statins,we recommend long-term aspirin therapy.In patients who are unable to take aspirin and in those with ahistory of gastrointestinal bleeding,clopidogrel is a reasonable alternative.Conclusions For some stable atherosclerotic CVD patients who are at high risk of cardiovascular events and at lowrisk for bleeding,a regimen of rivaroxaban and aspirin might be taken into consideration.Keywords Rivaroxaban,Atherosclerosis,Risk,EgyptBackgroundPatients with established coronary heart disease(CHD)or peripheral artery disease (PAD)have markedly higherrisks of subsequent cardiovascular events,including"Correspondencemyocardial infarction(MI),stroke,and death from car-Ahmed Bendarydiovascular disease(CVD).Therapeutic lifestyle changesahmed.bendari@fmed bu.edueg:dr_a_bendary@hotmailcomCardiology Department,Faculty of Medicine,Benha University,Benha,of proven benefit include multiple major modifiableEgyptrisk factors for CHD [elevated low-density lipoproteinNational Heart Institute,Giza Egypt(LDL)cholesterol,hypertension,smoking,obesity,physi-Cardiology Department,Faculty of Medicine,Menofia University,Shibincal inactivity,and diabetes to reduce risks of futureEl Kom,EgyptCardiology Department,Military Medical Academy,Caira,EgyptCVD events,and benefits are additive.Moreover,evi-sCardiology Department,Faculty of Medicine,Damietta University,dence-based doses of a high-intensity statin regardlessDamietta,Egyptof the baseline LDL cholesterol are also recommended.SpringerOpenThe Author(s)2023.Open AccessThis artide is licensed undera Creative Commons Attibution 40 Intemnational License,whichpermits use,sharing adaptation,distribution and repoducton in amy medium orfomat as long as you g
