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new england journal of medicine The established in 1812 October 5, 2017 vol. 377 no. 14 Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease J.W. Eikelboom, S.J. Connolly, J. Bosch, G.R. Dagenais, R.G. Hart, O. Shestakovska, R. Diaz, M. Alings, E.M. Lonn, S.S. Anand, P. Widimsky, M. Hori, A. Avezum, L.S. Piegas, K.R.H. Branch, J. Probstfield, D.L. Bhatt, J. Zhu, Y. Liang, A.P. Maggioni, P. Lopez‑Jaramillo, M. O’Donnell, A.K. Kakkar, K.A.A. Fox, A.N. Parkhomenko, G. Ertl, S. Störk, M. Keltai, L. Ryden, N. Pogosova, A.L. Dans, F. Lanas, P.J. Commerford, C. Torp‑Pedersen, T.J. Guzik, P.B. Verhamme, D. Vinereanu, J.-H. Kim, A.M. Tonkin, B.S. Lewis, C. Felix, K. Yusoff, P.G. Steg, K.P. Metsarinne, N. Cook Bruns, F. Misselwitz, E. Chen, D. Leong, and S. Yusuf, for the COMPASS Investigators*​​a bs t r ac t BACKGROUND We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86;