Evidence mapPaperPMID 35170216Full record

Trial reportJournal of thrombosis and haemostasis : JTH2022

Prevention of arterial and venous thrombotic events in symptomatic peripheral arterial disease patients after lower extremity revascularization in the VOYAGER PAD trial: Dual anticoagulant/antiplatelet regimen vs antiplatelet therapy alone.

Scott D Berkowitz, Rupert M Bauersachs, Michael Szarek, Mark R Nehler, E Sebastian Debus, Manesh R Patel, Sonia S Anand, Warren H Capell, Connie N Hess, Judy Hsia and 8 more

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of thrombosis and haemostasis : JTH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.6field-weighted citation impact, top 11% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
  2. Article
  3. Comparing Post-operative Anticoagulation: Rivaroxaban and Apixaban Demonstrate Similar Clot Strengths.European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery · 2025
    Article
  4. Article
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 13 institutions in 8 countries.

Scott D BerkowitzColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0002-9428-4408
Rupert M BauersachsCardiovascular Center Bethanien CCB, Frankfurt, Germany.ORCID 0000-0001-6192-1741
Michael SzarekColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0002-0046-0264
Mark R NehlerColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0003-1012-7307
E Sebastian DebusDepartment of Vascular Medicine, Vascular Surgery-Angiology-Endovascular Therapy, University of Hamburg-Eppendorf, Hamburg, Germany.ORCID 0000-0002-5664-6439
Manesh R PatelDuke Clinical Research Institute, Durham, North Carolina, USA.ORCID 0000-0002-2393-0855
Sonia S AnandDepartment of Medicine & Epidemiology, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-3692-7441
Warren H CapellColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0002-1073-3721
Connie N HessColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0002-5830-0511
Judy HsiaColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0002-3413-7836
Nicholas J LeeperDivision of Vascular Surgery, Department of Surgery, Stanford University, Stanford, California, USA.ORCID 0000-0002-0905-2806
David BrasilFELUMA-Faculdade de Ciencias Medicas de Minas Gerais School of Medicine, Belo Horizonte, Brazil.ORCID 0000-0002-3524-4043
Lajos MátyásB-A-Z Central University Teaching County Hospital Vascular and Endovascular Surgery, Miskolc, Hungary.ORCID 0000-0003-2725-8776
Rafael DiazEstudios Clínicos Latinoamérica - Instituto Cardiovascular de Rosario, Rosario, Argentina.
Marianne BrodmannDivision of Angiology, Medical University of Graz, Graz, Austria.ORCID 0000-0001-6493-3799
Eva MuehlhoferBayer AG, Research & Development, Wuppertal, Germany.ORCID 0000-0001-8213-232X
Lloyd P HaskellJanssen Research and Development, Raritan, New Jersey, USA.ORCID 0000-0002-2468-2523
Marc P BonacaColorado Prevention Center Clinical Research, Aurora, Colorado, USA.ORCID 0000-0002-9860-3584
University of Colorado Denver · USBayer (Germany) · DEClinical Research Institute · USEstudios Clínicos Latinoamérica · ARFaculdade de Ciências Médicas de Minas Gerais · BRJanssen (United States) · USJohannes Gutenberg University Mainz · DEMedical University of Graz · ATPopulation Health Research Institute · CAStanford University · USState University of New York · USUniversität Hamburg · DEUniversity of Miskolc · HU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVascular disease burden after lower extremity revascularization (LER) comprises more than the first event, more vascular beds than the local arteries, and more than one clinical event type.

objectivesAssess total arterial and venous thrombotic burden after LER for symptomatic peripheral artery disease (PAD) and effect of low-dose anticoagulation added to low-dose antiplatelet therapy. PATIENTS/

methodsVOYAGER PAD randomized 6564 symptomatic PAD patients undergoing LER to rivaroxaban 2.5 mg twice-daily or placebo on aspirin background. Marginal proportional-hazards models used to generate treatment hazard ratios and associated 95% CIs for first and total events; non-thrombotic deaths treated as competing terminal events. Incidence rates calculated as number of events per 100 patient-years follow-up.

resultsOver 2.5 years (median), first and total thrombotic event rates: 7.1 and 10.3 events/100 patient-years, respectively, in placebo group. Two-thirds (925/1372) of total thrombotic events (arterial 95%, venous 5%) were nonfatal first events. Nearly one-third of patients with first event had a second arterial or venous thrombotic event. Rivaroxaban plus aspirin reduced first and total arterial and venous thrombotic events to 5.4 and 7.9 events/100 patient-years, respectively, a reduction in total thrombotic events over aspirin of 23% (HR: 0.77, 95%CI: 0.67-0.89, p = .0005), preventing 6.1 total arterial and venous thrombotic events at 3 years.

conclusionsAssessing total arterial and venous thrombotic events, not just first events, provides more complete information about disease burden and absolute on-treatment impact. Following LER, judicious modulation of more than one coagulation pathway can provide broader benefit than intensifying inhibition of one hemostatic system component.

Indexed as

Endovascular ProceduresPeripheral Arterial DiseaseThrombosisAnticoagulantsArteriesAspirinHumansLower ExtremityPlatelet Aggregation InhibitorsRivaroxabanAnticoagulantsAspirinPlatelet Aggregation InhibitorsRivaroxabananticoagulantsatherosclerosisperipheral arterial diseaserivaroxabanthrombosisvenous thromboembolism

Identifiers

PMID35170216
PMCPMC9314576
OpenAlexW4212887787

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.