ACC 2021 | VOYAGER PAD: Usefulness of Rivaroxaban After Peripheral Angioplasty

Patients with peripheral vascular disease who undergo angioplasty in the lower limbs find benefit from treatment with rivaroxaban, according to the VOYAGER PAD study, presented at the scientific sessions of the American College of Cardiology (ACC) 2021 Congress and simultaneously published in JACC.

ACC 2021 | VOYAGER PAD: utilidad del rivaroxaban luego de una angioplastia periférica

Patients with said disease present a higher risk of ischemic events not only in the lower limbs, but in all vascular territory. We reviewed this when analyzing the SAFE-PAD study, in which a mortality of <50% was observed at three years in both treatment arms.

The VOYAGER PAD study showed that 2.5 mg of rivaroxaban twice a day reduces the first ischemic event by 15%. However, we had no information on its usefulness for subsequent events.

In this research, patients with peripheral vascular disease who underwent angioplasty in the lower limbs were randomized to rivaroxaban (2.5 mg twice a day) plus aspirin vs. aspirin alone.

The original primary endpoint was a composite of acute ischemic events in the lower limbs, infarction, stroke, or cardiovascular death. This analysis included subsequent events, like repeat revascularization and venous thromboembolism.

Rivaroxaban reduced the composite endpoint (hazard ratio [HR]: 0.86, 95% confidence interval [CI]: 0.75 to 0.98; p = 0.02), and vascular events overall (HR: 0.86; 95% CI: 0.79 to 0.95; p = 0.003).


Read also: ACC 2021 | SAFE-PAD: Paclitaxel-Eluting Devices in Peripheral Disease.


Based on the primary endpoint, we can estimate that rivaroxaban prevents 4.4 events, and 12.5 vascular events/100 patients in a three-year period.

Conclusion

Patients with symptomatic peripheral vascular disease who undergo lower limb revascularization can significantly reduce their risk of primary and subsequent events by taking rivaroxaban.

Original Title: Total Ischemic Event Reduction with Rivaroxaban after Peripheral Arterial Revascularization in the VOYAGER PAD Trial.

Reference: Rupert M. Bauersachs et al. J Am Coll Cardiol. 2021 May 7;S0735-1097(21)05016-6. Online ahead of print. doi: 10.1016/j.jacc.2021.05.003. 


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

TCT 2024 | SIRONA: Randomized Study Comparing Sirolimus-Coated vs Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Disease

This prospective, randomized, multicenter, investigator-initiated non-inferiority study compared the use of sirolimus-coated balloon (MagicTouch) vs paclitaxel-coated balloon in endovascular treatment.  The primary objective was to...

TCT 2024 | PEERLESS: Mechanical Thrombectomy with FlowTriever vs Catheter-Directed Thrombolysis in Intermediate Risk PTE

Pulmonary embolism (PE) continues to be the third cause of cardiovascular mortality. The current clinical guidelines recommend anticoagulation in intermediate risk patients presenting right...

STEACS and the Use of Bivalirudin vs. Heparin: In Search of BRIGHT-4 Outcomes

Various studies and registries have previously shown the impact of post-percutaneous coronary intervention (PCI) complications on the survival of patients with ST-segment elevation acute...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...