Use of rivaroxaban and acetylsalicylic acid as a combined treatment for peripheral arterial disease in Central Military Hospital

Authors

  • Rigoberto Román-Hernández Department of Peripheral Vascular Surgery, Central Military Hospital, CDMX
  • Rodrigo Banegas-Ruiz Department of Traumatology, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX
  • Claudia N. Jiménez-Nateras Department of Traumatology, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX
  • Manuel Martínez-Meraz Higher School of Medicine, IPN, CDMX
  • Carmen G. Torres-Alarcón Department of Blood Bank, Central Military Hospital, CDMX
  • José A. Espejel-Blancas Department of Angiology and Vascular Surgery, Angeles del Pedregal Hospital, CDMX
  • José Á. B. Colón Department of Angiology and Vascular Surgery, CMNSXXI, IMSS, CDMX
  • Yuri J. Caprielova Faculty of Medicine, UNAM, CDMX
  • Román A. R. Llergo Department of Surgery, High Specialty Regional Hospital Zumpango
  • Juan P. E. Torres Department of Pediatric Plastic and Reconstructive Surgery, HGCMN La Raza, IMSS, CDMX
  • German E. Mendoza-Barrera Department of General Surgery, Creighton University Medical Center, Omaha, Nebraska
  • Alan I. Valderrama-Treviño Laboratory of Experimental Immunotherapy and Tissue Engineering, Faculty of Medicine, UNAM, CDMX
  • Baltazar Barrera-Mera Department of Physiology, Faculty of Medicine, UNAM, CDMX

DOI:

https://doi.org/10.18203/2320-6012.ijrms20205415

Keywords:

Peripheral arterial disease, Rivaroxaban, Aspirin, Intermittent claudication, Critical ischemia, Amputation, Extremity salvaging

Abstract

Background: The objective of this research was to evaluate the behavior of 3 risk indicators for peripheral arterial disease in patients under oral treatment with rivaroxaban 2.5 mg every 12 hours plus, acetylsalicylic acid 100 mg every 24 hours. It was hypothesized that the oral combination of rivaroxaban and acetylsalicylic acid presents a therapeutic advantage over other treatments.

Methods: A prospective longitudinal and non-randomized study of a single center was performed. 59 patients with peripheral arterial disease were included and treated with acetylsalicylic acid + rivaroxaban. Peak systolic velocity, ankle-brachial index and C reactive protein index were evaluated.

Results: Significant changes were found at month 1 and 3 of follow-up in maximum systolic velocity, ankle-arm index and C-reactive protein index. The baseline peak systolic velocity (PSV) in the anterior tibial artery had significant differences after one month of treatment (p=0.001) and after 3 months (p=0.001). The baseline PSV in the posterior tibial artery had significant differences compared to the values found at the month of treatment (p=0.001) and 3 months (p=0.001). In the ankle-brachial index a baseline median of 0.790 was found, one month after the treatment of 0.795 (p=0.147) and 3 months after 0.800 (p=0.019). The mean baseline C-reactive protein obtained was 73.142 mg/l, at one month 87.233 mg/l (p=0.001) and at 3 months at 79.009 mg/l (p=0.294) with a standard deviation of 67.18, 74.78 and 69.69 respectively.

Conclusions: The combined use of acetylsalicylic acid and rivaroxaban allows a clinical improvement in patients with peripheral arterial disease.

Author Biographies

Rigoberto Román-Hernández, Department of Peripheral Vascular Surgery, Central Military Hospital, CDMX

Department of Peripheral Vascular Surgery. Central Military Hospital. CDMX. Mexico.

Rodrigo Banegas-Ruiz, Department of Traumatology, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX

Department of Traumatology. Rehabilitation Hospital. Luis Guillermo Ibarra Ibarra. CDMX. Mexico.

Claudia N. Jiménez-Nateras, Department of Traumatology, Rehabilitation Hospital, Luis Guillermo Ibarra Ibarra, CDMX

Department of Traumatology. Rehabilitation Hospital. Luis Guillermo Ibarra Ibarra. CDMX. Mexico.

Manuel Martínez-Meraz, Higher School of Medicine, IPN, CDMX

Research professor. Higher School of Medicine, IPN. CDMX. Mexico.

Carmen G. Torres-Alarcón, Department of Blood Bank, Central Military Hospital, CDMX

Department of blood bank. Central Military Hospital. CDMX. Mexico.

José A. Espejel-Blancas, Department of Angiology and Vascular Surgery, Angeles del Pedregal Hospital, CDMX

Department of angiology and vascular surgery, Angeles del Pedregal Hospital, CDMX, Mexico.

José Á. B. Colón, Department of Angiology and Vascular Surgery, CMNSXXI, IMSS, CDMX

Department of Angiology and Vascular Surgery, CMNSXXI, IMSS, CDMX, Mexico

Yuri J. Caprielova, Faculty of Medicine, UNAM, CDMX

Faculty of Medicine. UNAM. CDMX. Mexico.

Román A. R. Llergo, Department of Surgery, High Specialty Regional Hospital Zumpango

Department of Surgery. High Specialty Regional Hospital Zumpango. Mexico.

Juan P. E. Torres, Department of Pediatric Plastic and Reconstructive Surgery, HGCMN La Raza, IMSS, CDMX

Department of Pediatric Plastic and Reconstructive Surgery, HGCMN La Raza, IMSS, CDMX, Mexico.

German E. Mendoza-Barrera, Department of General Surgery, Creighton University Medical Center, Omaha, Nebraska

Department of General Surgery. Creighton University Medical Center, Omaha, Nebraska. USA.

Alan I. Valderrama-Treviño, Laboratory of Experimental Immunotherapy and Tissue Engineering, Faculty of Medicine, UNAM, CDMX

Laboratory of Experimental Immunotherapy and Tissue Engineering. Faculty of Medicine. UNAM. CDMX. Mexico.

Baltazar Barrera-Mera, Department of Physiology, Faculty of Medicine, UNAM, CDMX

Department of Physiology, Faculty of Medicine, UNAM, CDMX, Mexico

 

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Published

2020-12-28

How to Cite

Román-Hernández, R., Banegas-Ruiz, R., Jiménez-Nateras, C. N., Martínez-Meraz, M., Torres-Alarcón, C. G., Espejel-Blancas, J. A., Colón, J. Á. B., Caprielova, Y. J., Llergo, R. A. R., Torres, J. P. E., Mendoza-Barrera, G. E., Valderrama-Treviño, A. I., & Barrera-Mera, B. (2020). Use of rivaroxaban and acetylsalicylic acid as a combined treatment for peripheral arterial disease in Central Military Hospital. International Journal of Research in Medical Sciences, 9(1), 15–21. https://doi.org/10.18203/2320-6012.ijrms20205415

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Original Research Articles