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Rivaroxaban plus aspirin after lower-extremity revascularization.

Graham R McClure1,2, John Eikelboom1,3

  • 1Population Health Research Institute, Hamilton, ON, Canada.

Expert Review of Hematology
|November 19, 2024
PubMed
Summary
This summary is machine-generated.

Low-dose rivaroxaban plus aspirin significantly reduces adverse cardiac and limb events after lower extremity revascularization. This combination therapy offers a superior antithrombotic strategy compared to aspirin alone, despite limited guideline adoption.

Keywords:
Peripheral revascularizationdual pathway inhibitionlower extremity angioplasty and stentinglower extremity open revascularizationperipheral vascular diseasevascular risk reduction

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Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Pharmacology

Background:

  • Peripheral revascularization patients face high rates of adverse cardiac and limb events.
  • Current antiplatelet therapy is insufficient for risk reduction.
  • Optimizing antithrombotic strategies is crucial.

Purpose of the Study:

  • To review rivaroxaban's profile.
  • To summarize efficacy and safety of rivaroxaban plus aspirin post-revascularization.
  • To examine barriers to adopting this combination therapy.

Main Methods:

  • Review of recent large, randomized trials.
  • Analysis of drug profiles and clinical data.
  • Examination of societal guideline recommendations.

Main Results:

  • Rivaroxaban plus aspirin reduces cardiac and limb events.
  • This combination maintains an acceptable bleeding profile.
  • Current guidelines have not incorporated this evidence.

Conclusions:

  • Rivaroxaban plus aspirin is the only regimen shown to reduce both cardiac and limb events post-peripheral revascularization.
  • Updating societal guidelines is urgently needed.
  • Further research on dual antiplatelet therapy is warranted.