VOYAGER PAD
Vascular Outcomes Study of ASA Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD
Paciente / Población Intervención / Exposición Comparación Desenlace
In 6,564 patients with peripheral artery disease after lower-extremity revascularisation, rivaroxaban 2.5 mg twice daily plus aspirin reduced acute limb ischaemia, major amputation, myocardial infarction, ischaemic stroke or cardiovascular death compared with aspirin alone.
N
6564
Diseño
Double-blind RCT
Desenlace
Composite of acute limb ischaemia, major amputation, MI, ischaemic stroke or CV death
Relevancia
2
Resultado17.3 % vs 19.9 % at 3 years (HR 0.85; 95 % CI 0.76–0.96; p=0.009). ISTH major bleeding 5.94 % vs 4.06 % (HR 1.42; 95 % CI 1.10–1.84).
Bonaca MP, Bauersachs RM, et al. N Engl J Med. 2020;382(21):1994-2004. 10.1056/NEJMoa2000052
Discusión y crítica
The benefit is driven largely by acute limb ischaemia while major bleeding rises significantly, so selection by bleeding risk is essential. It is the only positive antithrombotic trial in the post-revascularisation PAD population and anchors dual-pathway inhibition in the guideline.