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“The teachable critical appraisal point is that high-risk does not guarantee greater benefit. The control arm event rates were highest in TRACK (12% per year) vs VOYAGER PAD (8% per year) and COMPASS (5% per year).”
“Findings reported here have important clinical implications for treating cardiovascular risk in patients with advanced CKD. Clinical decisions regarding anticoagulation in people with advanced kidney disease should not be extrapolated from other cardiovascular populations. This trial underscores the need for dedicated cardiovascular outcome trials in people with advanced CKD.”
“In patients with advanced CKD at high cardiovascular risk, low-dose rivaroxaban did not reduce the risk of the composite cardiovascular outcome. Major bleeding events were significantly more frequent with low-dose rivaroxaban than with placebo.”
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Badve et al. (2026) studied this question.