Key result
Low-dose rivaroxaban plus aspirin reduces major events by ~4% absolute after PAD revascularization.
Why the study?
The risk-benefit profile of low-dose rivaroxaban in patients ≥75 years with peripheral artery disease after lower extremity revascularization had not been described.
Does low-dose rivaroxaban plus aspirin reduce the composite of acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke, or cardiovascular death in older patients with peripheral artery disease after lower extremity revascularization?
Population
6564 randomized PAD patients after lower extremity revascularization, including 1330 aged >75 years
Comparison
Rivaroxaban 2.5 mg twice/day plus aspirin 100 mg/day vs placebo
Design
Secondary analysis of a randomized trial
Follow-up
3-year
Authors
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Supports low-dose rivaroxaban plus aspirin in PAD patients ≥75 years post-revascularization; extends evidence with consistent ischemic benefit and no excess bleeding.
RCT (n=6,564)
Randomized
Does low-dose rivaroxaban plus aspirin reduce the composite of acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke, or cardiovascular death in older patients with peripheral artery disease after lower extremity revascularization?
Effect estimate: ARR 3.8%
Low-dose rivaroxaban plus aspirin provides consistent ischemic benefits without excess fatal or intracranial bleeding in patients ≥75 years with PAD after lower extremity revascularization.
Krantz et al. (2021) conducted an RCT in Peripheral artery disease (PAD) after lower extremity revascularization (LER) (n=6,564). Rivaroxaban plus aspirin vs. Placebo was evaluated on Composite of acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke, or cardiovascular death (ARR 3.8%). Low-dose rivaroxaban plus aspirin in patients with PAD after lower extremity revascularization yielded an absolute risk reduction of 3.8% for the primary endpoint, with consistent benefits regardless of age.
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