Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization
BackgroundTo evaluate the efficacy and safety of clopidogrel-rivaroxaban combination compared to aspirin-rivaroxaban combination in patients with symptomatic peripheral artery disease (PAD).MethodsConsecutive patients with symptomatic PAD patients were analyzed from January, 2018 to June, 2022 at Na...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1485380/full |
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| author | Min Lu Jiaqi Li Huanyu Ni Tong Qiao Baoyan Wang |
| author_facet | Min Lu Jiaqi Li Huanyu Ni Tong Qiao Baoyan Wang |
| author_sort | Min Lu |
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| description | BackgroundTo evaluate the efficacy and safety of clopidogrel-rivaroxaban combination compared to aspirin-rivaroxaban combination in patients with symptomatic peripheral artery disease (PAD).MethodsConsecutive patients with symptomatic PAD patients were analyzed from January, 2018 to June, 2022 at Nanjing Drum Tower Hospital. Patients were divided into two groups based on the antithrombotic therapy. The primary efficacy outcome was a composite of major adverse cardiovascular events (MACE) and major adverse limb events (MALE), and the primary safety outcome was major bleeding. Patients were followed until the first occurrence of any outcomes or the study end date (30 June 2024).ResultsA total of 695 patients were enrolled into this study. The clopidogrel-rivaroxaban combination significantly reduced the risk of composite outcome (HR: 0.59, 95%CI: 0.41–0.83) without increasing the risk of major bleeding (HR: 0.68, 95%CI: 0.27–1.69). When analyzed separately, clopidogrel-rivaroxaban combination was associated with a reduced risk of MALE (HR: 0.61, 95%CI: 0.41–0.91), although no significant differences were observed in terms of MACE (HR: 0.64, 95%CI: 0.34–1.20) or all bleeding events (HR: 1.00, 95%CI: 0.52–1.93). In the subgroup analysis, there were no significant interactions between the treatment groups and the subgroups of age, diabetes, lesion sites, Rutherford classifications and renal function for composite outcome, MACE and MALE.ConclusionThe clopidogrel-rivaroxaban combination in PAD patients may offer enhanced cardiovascular protection without increasing the risk of bleeding complications. These findings suggested that clopidogrel could be a superior alternative to aspirin in dual antithrombotic therapy for PAD management. |
| format | Article |
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| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj-art-0cb40937945a435b84f269995e89e8fe2025-01-13T06:11:01ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011510.3389/fphar.2024.14853801485380Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularizationMin Lu0Jiaqi Li1Huanyu Ni2Tong Qiao3Baoyan Wang4Changshu No.2 People’s Hospital, Affiliated Changshu Hospital of Nantong University, Changshu, Jiangsu, ChinaNanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, ChinaNanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, ChinaNanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, ChinaNanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, ChinaBackgroundTo evaluate the efficacy and safety of clopidogrel-rivaroxaban combination compared to aspirin-rivaroxaban combination in patients with symptomatic peripheral artery disease (PAD).MethodsConsecutive patients with symptomatic PAD patients were analyzed from January, 2018 to June, 2022 at Nanjing Drum Tower Hospital. Patients were divided into two groups based on the antithrombotic therapy. The primary efficacy outcome was a composite of major adverse cardiovascular events (MACE) and major adverse limb events (MALE), and the primary safety outcome was major bleeding. Patients were followed until the first occurrence of any outcomes or the study end date (30 June 2024).ResultsA total of 695 patients were enrolled into this study. The clopidogrel-rivaroxaban combination significantly reduced the risk of composite outcome (HR: 0.59, 95%CI: 0.41–0.83) without increasing the risk of major bleeding (HR: 0.68, 95%CI: 0.27–1.69). When analyzed separately, clopidogrel-rivaroxaban combination was associated with a reduced risk of MALE (HR: 0.61, 95%CI: 0.41–0.91), although no significant differences were observed in terms of MACE (HR: 0.64, 95%CI: 0.34–1.20) or all bleeding events (HR: 1.00, 95%CI: 0.52–1.93). In the subgroup analysis, there were no significant interactions between the treatment groups and the subgroups of age, diabetes, lesion sites, Rutherford classifications and renal function for composite outcome, MACE and MALE.ConclusionThe clopidogrel-rivaroxaban combination in PAD patients may offer enhanced cardiovascular protection without increasing the risk of bleeding complications. These findings suggested that clopidogrel could be a superior alternative to aspirin in dual antithrombotic therapy for PAD management.https://www.frontiersin.org/articles/10.3389/fphar.2024.1485380/fullperipheral artery diseaseclopidogrelrivaroxabanefficacysafety |
| spellingShingle | Min Lu Jiaqi Li Huanyu Ni Tong Qiao Baoyan Wang Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization Frontiers in Pharmacology peripheral artery disease clopidogrel rivaroxaban efficacy safety |
| title | Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization |
| title_full | Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization |
| title_fullStr | Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization |
| title_full_unstemmed | Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization |
| title_short | Clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization |
| title_sort | clopidogrel combined with rivaroxaban in peripheral artery disease after revascularization |
| topic | peripheral artery disease clopidogrel rivaroxaban efficacy safety |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1485380/full |
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