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Rivaroxaban effective in treating VTE in symptomatic peripheral artery disease after lower extremity - Video

Published On 2022-06-30T10:00:44+05:30  |  Updated On 30 Jun 2022 2:50 PM IST
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Overview

A new cohort study found that 6564 patients undergoing lower extremity revascularization for peripheral arterial disease, the 3-year rate of venous thromboembolism (VTE) in patients receiving placebo was 1.66%, and low-dose rivaroxaban plus aspirin was associated with reduced risk for venous thromboembolism.

Previous studies have observed an association between the burden of atherosclerotic vascular disease and the risk of venous thromboembolism (VTE). The association is not known in peripheral artery disease (PAD) after lower extremity revascularization (LER).

The study was a global, multicenter cohort study that used data from the Vascular Outcomes Study of ASA (acetylsalicylic acid) Along With Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD (VOYAGER PAD) randomized clinical trial, which enrolled patients from 2015 to 2018 with median follow-up of 28 months. Participants included patients with peripheral artery disease undergoing lower extremity revascularization. Patients with an indication for therapeutic anticoagulation were excluded. Data were analyzed from September 2020 to September 2021.

Randomization to rivaroxaban 2.5 mg twice daily or placebo on a background of aspirin 100 mg daily; short-term clopidogrel was used at the discretion of the treating physician.

Among 6564 patients, 66 patients had at least 1 venous thromboembolism. The 3-year rate of venous thromboembolism in patients receiving placebo was 1.7%. hypertension was 2.11, prior amputation 2.07, and older age 1.81 were associated with increased risk of venous thromboembolism. venous thromboembolism was associated with risk of subsequent mortality of 7.22. Compared with aspirin alone, rivaroxaban plus aspirin was associated with lower venous thromboembolism risk of 0.61 with benefit apparent early and sustained over time. This association was not modified by use of clopidogrel at randomization without clopidogrel: 0.55 with clopidogrel 0.69.

Researchers conclude this study there was continuous risk for venous thromboembolism after lower extremity revascularization in patients with peripheral arterial disease. Low-dose rivaroxaban plus aspirin was associated with lower venous thromboembolism risk compared with aspirin alone, with benefits apparent early and continued over time.

Reference: Hess CN, Szarek M, Anand SS, et al. Rivaroxaban and Risk of Venous Thromboembolism in Patients With Symptomatic Peripheral Artery Disease After Lower Extremity Revascularization. JAMA Netw Open. 2022;5(6):e2215580; doi:10.1001/jamanetworkopen.2022.15580.

Speakers

Isra Zaman

B.Sc Life Sciences, M.Sc Biotechnology, B.Ed

Isra Zaman is a Life Science graduate from Daulat Ram College, Delhi University, and a postgraduate in Biotechnology from Amity University. She has a flair for writing, and her roles at Medicaldialogues include that of a Sr. content writer and a medical correspondent. Her news pieces cover recent discoveries and updates from the health and medicine sector. She can be reached at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751
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