AHA: Vorapaxar Reduces Limb Ischemia in PAD

Does not reduce risk of cardiovascular death, myocardial infarction, stroke; ups bleeding risk

FRIDAY, June 22 (HealthDay News) -- For patients with peripheral artery disease (PAD), treatment with the platelet inhibitor vorapaxar significantly reduces the risk of hospitalization for acute limb ischemia and arterial revascularization, according to a study presented during the American Heart Association's Emerging Science Series Webinar, held on June 20.

Marc P. Bonaca, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues conducted a randomized placebo-controlled trial of 2.5 mg daily vorapaxar in addition to standard care, involving 3,787 patients with PAD. Participants with a history of claudication symptoms and either an ankle brachial index of <0.85 or prior peripheral revascularization for limb ischemia were deemed eligible.

The researchers observed no significant difference in the primary end point (composite of cardiovascular death, myocardial infarction, or stroke) in patients receiving vorapaxar or placebo. For patients randomized to vorapaxar there were significantly lower rates of hospitalization for acute limb ischemia (2.3 versus 3.9 percent; P = 0.006) and peripheral arterial revascularization (18.4 versus 22.2 percent; P = 0.017). Vorapaxar was associated with a significantly increased risk of bleeding, including intracerebral hemorrhage.

"This is the first outpatient therapy that has been shown to reduce the risk of blood clots and the need for artery opening revascularization procedures in the legs in patients with PAD," Escolar said in a statement. "For clinicians and researchers, these data show the potential for therapies that can reduce leg problems in patients with PAD rather than just overall cardiovascular risk."

Several authors disclosed financial ties to pharmaceutical companies, including Merck, which funded the study and developed vorapaxar.

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