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Identifying the highest risk vascular patients: Insights from the XATOA registry.

Publication ,  Journal Article
Anand, SS; Aboyans, V; Bosch, J; Debus, S; Gay, A; Patel, MR; Vogtländer, K; Welsh, RC; Zeymer, U; Fox, KAA; XATOA Steering Committee
Published in: American heart journal
March 2024

Patients with coronary and peripheral artery disease (PAD) have a residual risk of major adverse cardiovascular and limb events despite standards of care. Among patients with coronary artery disease (CAD) and/or PAD selected for low dose rivaroxaban (2.5 mg BID) and aspirin, we sought to determine the highest risk vascular patients.Xarelto pluc Acetylsalicylic acid: Treatment patterns and Outcomes in patients with Atherosclerosis (XATOA) is a single-arm registry of CAD and/or PAD patients. All participants were initiated on low dose rivaroxaban (2.5 mg BID) and aspirin. We report the incidence risk of major adverse cardiovascular events (MACE) or major adverse limb events (MALE) and major bleeding. A classification and regression tree analysis determined independent subgroups.Between November 2018 and May 2020, 5,808 participants were enrolled in XATOA; 5,532 were included in the full analysis. The median follow-up (interquartile range) was 462 (371-577) days. The incidence risk per 100 patient-years of MACE or MALE was highest among participants with polyvascular disease (2 or more vascular beds affected, n = 2,889). The incidence risk was 9.16 versus 2.48 per 100 patient-years in polyvascular and nonpolyvascular patients respectively. Other subgroups of high-risk patients included participants 75 years or older, with a history of diabetes, heart failure, or chronic renal insufficiency (CRI). Rates of major bleeding were low overall. A classification and regression tree analysis showed that polyvascular disease was the most dominant factor separating higher from lower risk participants, and this was heightened with CRI or diabetes.Patients with polyvascular disease represent a substantial subset of patients in clinical practice and should be prioritized to receive maximal medical therapy including low dose rivaroxaban (2.5 mg BID) and aspirin.

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Published In

American heart journal

DOI

EISSN

1097-6744

ISSN

0002-8703

Publication Date

March 2024

Volume

269

Start / End Page

191 / 200

Related Subject Headings

  • Rivaroxaban
  • Registries
  • Platelet Aggregation Inhibitors
  • Peripheral Arterial Disease
  • Humans
  • Hemorrhage
  • Factor Xa Inhibitors
  • Drug Therapy, Combination
  • Diabetes Mellitus
  • Coronary Artery Disease
 

Citation

APA
Chicago
ICMJE
MLA
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Anand, S. S., Aboyans, V., Bosch, J., Debus, S., Gay, A., Patel, M. R., … XATOA Steering Committee. (2024). Identifying the highest risk vascular patients: Insights from the XATOA registry. American Heart Journal, 269, 191–200. https://doi.org/10.1016/j.ahj.2024.01.001
Anand, Sonia S., Victor Aboyans, Jackie Bosch, Sebastian Debus, Alain Gay, Manesh R. Patel, Kai Vogtländer, et al. “Identifying the highest risk vascular patients: Insights from the XATOA registry.American Heart Journal 269 (March 2024): 191–200. https://doi.org/10.1016/j.ahj.2024.01.001.
Anand SS, Aboyans V, Bosch J, Debus S, Gay A, Patel MR, et al. Identifying the highest risk vascular patients: Insights from the XATOA registry. American heart journal. 2024 Mar;269:191–200.
Anand, Sonia S., et al. “Identifying the highest risk vascular patients: Insights from the XATOA registry.American Heart Journal, vol. 269, Mar. 2024, pp. 191–200. Epmc, doi:10.1016/j.ahj.2024.01.001.
Anand SS, Aboyans V, Bosch J, Debus S, Gay A, Patel MR, Vogtländer K, Welsh RC, Zeymer U, Fox KAA, XATOA Steering Committee. Identifying the highest risk vascular patients: Insights from the XATOA registry. American heart journal. 2024 Mar;269:191–200.
Journal cover image

Published In

American heart journal

DOI

EISSN

1097-6744

ISSN

0002-8703

Publication Date

March 2024

Volume

269

Start / End Page

191 / 200

Related Subject Headings

  • Rivaroxaban
  • Registries
  • Platelet Aggregation Inhibitors
  • Peripheral Arterial Disease
  • Humans
  • Hemorrhage
  • Factor Xa Inhibitors
  • Drug Therapy, Combination
  • Diabetes Mellitus
  • Coronary Artery Disease