Rupert Bauersachs (Darmstadt, Germany) talks to Cardiovascular News about the VOYAGER-PAD trial, the results of which he presented at the American College of Cardiology’s 70th Annual Scientific Session (ACC.21, 15–17 May, virtual) and which highlighted a reduced risk of ischaemic events in peripheral artierial disease (PAD) patients receiving rivaroxaban.
The analysis, presented by Bauersachs, focused not only on first events but on the totality of events, and showed that one third of all patients had at least one further subsequent event. In the placebo group there was an event rate of more than 88 per 100 patients, which was reduced “significantly”–an absolute risk reduction of 12.5–with the use of rivaroxaban.
A key lesson from VOYAGER-PAD is that those patients with PAD who have to undergo lower extremity revascularisation have a “high risk of first events but also a very high risk of subsequent complications”, says Bauersachs, adding that “if we had only looked at the first events we would have really missed 80% of the overall benefit of rivaroxaban”.
Concluding, Bauersachs states that in future trials, the totality of events rather than just the first events must be analysed “otherwise we miss the whole burden of disease and we may miss the benefit of the treatment”.