Comparison of rivaroxaban-based dual antithrombotic and antiplatelet therapies for symptomatic patients with lower-extremity peripheral artery disease post-revascularization: a retrospective cohort study.
Ther Adv Chronic Dis
; 14: 20406223231213262, 2023.
Article
en En
| MEDLINE
| ID: mdl-38085917
ABSTRACT
Background: Serious cardiovascular and limb events are common adverse effects in patients with symptomatic lower-extremity peripheral artery disease (LE-PAD).Few studies have reported the benefits of dual antithrombotic therapy with rivaroxaban in patients with high risk of LE-PAD in Asian populations. Methods: We collected data from in-patients with LE-PAD from January 1, 2018 to December 31, 2021.Depending on the antithrombotic medication administered, we classified the patients into antiplatelet therapy (e.g., aspirin and clopidogrel; APT group) and antiplatelet therapy combined with rivaroxaban (RAPT group) groups.The primary efficacy outcome was major adverse cardiovascular events (MACE), which was a composite of myocardial infarction, ischemic stroke or death from cardiovascular causes. The primary safety outcome was major bleeding.Secondary clinical outcomes included myocardial infarction, ischemic stroke, death from cardiovascular causes, clinically relevant non-major (CRNM) bleeding, and major adverse limb events (MALE), including urgent revascularization, acute limb ischemia, and major amputation.Follow-up continued until death or the end of the study (March 31, 2023). Results: The RAPT group had a lower risk of primary composite efficacy outcome and a non-significant increase in the risk of major bleeding than the APT group.The risk of secondary efficacy was significantly lower in the RAPT group than in the APT groups. The incidence of CRNM bleeding varied between the two groups.The subgroups and treatment groups had no significant interactions with the risk of composite efficacy outcomes. Conclusions: Rivaroxaban-based dual antithrombotic therapy has a clear therapeutic advantage over single antiplatelet therapy in Asian populations and does not increase the risk of major bleeding.Rivaroxaban-based combination therapy reduces the risk of serious adverse cardiovascular and limb events with an acceptable safety profile.
Comparison of rivaroxaban-based dual antithrombotic and antiplatelet therapies for symptomatic patients with lower-extremity peripheral artery disease post-revascularization: a retrospective cohort study.
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Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Ther Adv Chronic Dis
Año:
2023
Tipo del documento:
Article
País de afiliación:
China
Pais de publicación:
Estados Unidos