Evidence mapPaperPMID 34711335Full record

Trial reportJournal of the American College of Cardiology2021

Safety and Effectiveness of Paclitaxel Drug-Coated Devices in Peripheral Artery Revascularization: Insights From VOYAGER PAD.

Connie N Hess, Manesh R Patel, Rupert M Bauersachs, Sonia S Anand, E Sebastian Debus, Mark R Nehler, Fabrizio Fanelli, Robert W Yeh, Eric A Secemsky, Joshua A Beckman and 9 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American College of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02504216 (An International, Multicenter, Randomized, Double-blind, Placebo-controlled Phase 3 Trial Investigating the Efficacy and Safety of Rivaroxaban to Reduce the Risk of Major Thrombotic Vascular Events in Patients With Symptomatic Peripheral Artery Disease Undergoing Lower Extremity Revascularization Procedures), which is not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02504216 phase3completednot on this map

An International, Multicenter, Randomized, Double-blind, Placebo-controlled Phase 3 Trial Investigating the Efficacy and Safety of Rivaroxaban to Reduce the Risk of Major Thrombotic Vascular Events in Patients With Symptomatic Peripheral Artery Disease Undergoing Lower Extremity Revascularization Procedures

TypeinterventionalSponsorBayerRan2015 to 2020Enrolled6,564ConditionsPeripheral Artery DiseaseArmsRivaroxaban (Xarelto, BAY59-7939), Rivaroxaban-Placebo
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 33 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Drug-eluting devices for lower limb peripheral arterial disease.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024
    Review
  7. Review
  8. Article
  9. Algorithm of Femoropopliteal Endovascular Treatment.Medicina (Kaunas, Lithuania) · 2022
    Article
  10. Article
  11. State-of-the-Art Endovascular Therapies for the Femoropopliteal Segment: Are We There Yet?Journal of the Society for Cardiovascular Angiography & Interventions
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 10 institutions in 4 countries.

Connie N HessDepartment of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA; CPC Clinical Research, Aurora, Colorado, USA. Electronic address: connie.hess@cuanschutz.edu.
Manesh R PatelDuke Clinical Research Institute, Division of Cardiology, Duke University, Durham, North Carolina, USA.
Rupert M BauersachsDepartment of Vascular Medicine, Klinikum Darmstadt, Darmstadt, and Center for Thrombosis and Hemostasis, University of Mainz, Mainz, Germany.
Sonia S AnandPopulation Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
E Sebastian DebusDepartment of Vascular Medicine, Vascular Surgery-Angiology-Endovascular Therapy, University of Hamburg-Eppendorf, Hamburg, Germany.
Mark R NehlerCPC Clinical Research, Aurora, Colorado, USA; Department of Surgery, Division of Vascular Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
Fabrizio FanelliVascular and Interventional Radiology Department, Careggi University Hospital, University of Florence, Florence, Italy.
Robert W YehSmith Center for Outcomes Research in Cardiology, Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Eric A SecemskySmith Center for Outcomes Research in Cardiology, Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Joshua A BeckmanDepartment of Medicine, Division of Cardiology, Vanderbilt University, Nashville, Tennessee, USA.
Laura MauriMedtronic, Inc, Minneapolis, Minnesota, USA.
Nicholas GovsyeyevCPC Clinical Research, Aurora, Colorado, USA; Department of Surgery, Division of Vascular Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
Warren H CapellCPC Clinical Research, Aurora, Colorado, USA; Department of Medicine, Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Taylor BrackinCPC Clinical Research, Aurora, Colorado, USA.
Scott D BerkowitzThrombosis Group Head, Clinical Development, Bayer U.S., Whippany, New Jersey, USA.
Eva MuehlhoferBayer, Wuppertal, Germany.
Lloyd P HaskellJanssen Research and Development, Raritan, New Jersey, USA.
William R HiattDepartment of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA; CPC Clinical Research, Aurora, Colorado, USA.
Marc P BonacaDepartment of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA; CPC Clinical Research, Aurora, Colorado, USA.
Bayer (Germany) · DEClinical Research Institute · USHamilton Health Sciences · CAJanssen (United States) · USJohannes Gutenberg University Mainz · DEMedtronic (United States) · USMeridian Clinical Research · USUniversität Hamburg · DEUniversity of Florence · ITVanderbilt University · US

Funding

NHLBI NIH HHS K23 HL150290
6 · The paper itself

Abstract

backgroundPaclitaxel drug-coated devices (DCDs) were developed to improve lower extremity revascularization (LER) patency in peripheral artery disease (PAD) but have been associated with long-term mortality.

objectivesThis study assessed DCD safety and effectiveness in LER for PAD.

methodsVOYAGER PAD (Vascular Outcomes Study of ASA [acetylsalicylic acid] Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD) randomized patients with PAD who underwent LER to rivaroxaban or placebo. The primary VOYAGER PAD study efficacy and safety outcomes were composite cardiovascular and limb events and Thrombolysis In Myocardial Infarction major bleeding. For prespecified DCD analyses, primary safety and effectiveness outcomes were mortality and unplanned index limb revascularization (UILR). Major adverse limb events (MALE) were a secondary outcome. Inverse probability treatment weighting was used to account for each subject's propensity for DCD treatment. Effects of rivaroxaban were assessed with Cox proportional hazards models.

resultsAmong 4,316 patients who underwent LER, 3,478 (80.6%) were treated for claudication, and 1,342 (31.1%) received DCDs. Median follow-up was 31 months, vital status was ascertained in 99.6% of patients, and there were 394 deaths. After weighting, DCDs were not associated with mortality (HR: 0.95; 95% CI: 0.83-1.09) or MALE (HR: 1.08; 95% CI: 0.90-1.30) but were associated with reduced UILR (3-year Kaplan-Meier: 21.5% vs 24.6%; HR: 0.84; 95% CI: 0.76-0.92). Irrespective of DCD use, consistent benefit of rivaroxaban for composite cardiovascular and limb events (P

conclusionsIn >4,000 patients with PAD who underwent LER, DCDs were not associated with mortality or MALE but were associated with persistent reduction in UILR. These findings provide insight into the safety and effectiveness of DCDs in PAD. (Vascular Outcomes Study of ASA [acetylsalicylic acid] Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD [VOYAGER PAD]; NCT02504216).

Indexed as

Cardiovascular DiseasesChronic Limb-Threatening IschemiaDrug-Eluting StentsEndovascular ProceduresPeripheral Arterial DiseasePostoperative ComplicationsAntineoplastic Agents, PhytogenicFemaleHumansKaplan-Meier EstimateMaleMiddle AgedOutcome Assessment, Health CarePaclitaxelProportional Hazards ModelsAntineoplastic Agents, PhytogenicPaclitaxeloutcomesperipheral artery diseaserevascularization

Identifiers

PMID34711335
PMCPMC12698318
OpenAlexW3209155939

What Socratic holds

Textmetadata
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.