Inclusion Criteria:  Patients with chronic coronary syndrome (at least 1 year after having a myocardial infarction) on aspirin monotherapy will be eligible for this study. They have to have at least one of these additional risk factors:  Diffuse coronary artery disease. Peripheral vascular disease Diabetes Chronic kidney disease (eGFR<60 ml/unit/1.73 m2)  Exclusion Criteria:  Allergy to either rivaroxaban or ticagrelor Requirement for anticoagulation or P2Y12 inhibitor therapy Anemia (hemoglobin < 10 g/dL) Severe renal impairment (eGFR < 30 ml/unit/1.73 m2) Bleeding disorders Significant liver impairment resulting in deranged clotting parameters Any history of intracranial hemorrhage Stroke within 6 months History of gastrointestinal bleed within 6 months Major surgery within 1 month Patients with inflammatory conditions Concomitant treatment with immunosuppressive therapy, inhibitors or inducers of P glycoprotein or CYP3A4 enzymes (eg. azole antifungals, ritonavir, erythromycin, clarithromycin, rifampicin) Concomitant treatment with antidepressants (selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors) Pregnancy Inability to give written consent