Article Impact Level: HIGH Data Quality: STRONG Dr. Ritika Verma et al
Points
- A small dose of rivaroxaban could be considered to lessen the likelihood of venous thromboembolism among individuals with peripheral arterial disorder (PAD) who undertake lower-limb revascularization.
- Following revascularization of the lower limbs, venous thromboembolism rates appear greater in people experiencing the poly-vascular atherosclerotic disorder.
- Advanced age, overweight, and increased cardiovascular events are possible causes of venous thromboembolism.
- The prevalence of vascular atherosclerosis and the likelihood of venous thrombosis have been linked in previous studies. However, this has yet to be described briefly concerning PAD after getting lower-limb revascularization.
Summary
Atherosclerosis in other organ systems and PAD frequently overlap. The latter is linked to greater chances of myocardial ischemia, cerebrovascular accidents, acute limb ischemia, and chronic limb-threatening ischemia. The incidence of venous thromboembolism, however, can also be increased in people with PAD. Molecular factors like systemic inflammation or thrombophilia, as well as common health issues like aging and being overweight, may be the root cause of these circulatory abnormalities. In a composite study of two antiplatelet experiments, the observed venous thromboembolism frequency among individuals with dyslipidemia, which was irrelevant to the capillary region, was 0.3% per year.
As this was happening, higher 3-year venous thromboembolism frequencies were linked to poly-vascular atherosclerotic disease. Hess and colleagues performed a post-hoc evaluation of VOYAGER-PAD. They assessed the frequencies and potential risks of venous thromboembolism among individuals with PAD and lower limb catheterization.
Throughout this trial, which was done from 2015 to 2018, 6,564 PAD patients who needed lower-limb catheterization due to claudication were randomly assigned to receive either aspirin 100 mg once a day or rivaroxaban 2.5 mg twice daily. The principal combined result, primarily amputation, myocardial infarction, hemorrhagic stroke, or mortality from cardiovascular causes, was considerably less common in people taking combination therapy at three years. Inside the study design, symptomatic venous thromboembolism was a pre-identified experimental endpoint. Low-dose rivaroxaban and aspirin administration was linked to a 39% adjusted hazard decrease of venous thromboembolism.
So, the results of these studies show that a double-route blockage approach with aspirin and a small dose of rivaroxaban can help lower the risk of problems from arterial and vein thrombosis during leg transplantation. A more aggressive antiplatelet treatment has also been proven to help lower the risk for venous thromboembolism in individuals with poly-vascular atherosclerosis.
In order to develop new recommendations for antiplatelet or antithrombotic medicines following lower-limb revascularization in individuals with PAD, more study is required to identify the ideal standard treatment for reducing the risk of venous thromboembolism.
Link to the article: https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/07/11/56/Rivaroxaban-and-Venous-Thromboembolism-After-Revascularization-For-Symptomatic-PAD
References Verma, R., Young, M., & Henkin, S. (2023, February 7). Rivaroxaban and Venous Thromboembolism After Revascularization For Symptomatic Peripheral Artery Disease. American College of Cardiology; American College of Cardiology. https://www.acc.org/Latest-in-Cardiology/Articles/2023/02/07/11/56/Rivaroxaban-and-Venous-Thromboembolism-After-Revascularization-For-Symptomatic-PAD
