The Impact of Factor Xa Inhibition on Thrombosis, Platelet Activation, and Endothelial Function in Peripheral Artery Disease

NCT ID: NCT05009862

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-19

Study Completion Date

2026-03-01

Brief Summary

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The purpose of this study is to understand how the drug rivaroxaban improves symptoms associated with peripheral artery disease.

Detailed Description

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The Primary Investigator's central hypothesis is that activation of thrombotic pathways and downstream effectors of factor Xa signaling contribute to the development of PAD and its complications.

Aim 1: To assess the impact of rivaroxaban on macrovascular endothelial function in a randomized, double-blind, placebo-controlled crossover intervention in humans with PAD.

Aim 2: To assess the impact of rivaroxaban on PAR-1-mediated platelet activation in addition to its pleiotropic effects on thrombosis, thrombolysis, and inflammation in a randomized, double-blind, placebo-controlled crossover intervention in humans with PAD.

Conditions

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Peripheral Arterial Disease

Keywords

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Rivaroxaban Peripheral Artery Disease PAD Thrombosis Anticoagulant

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Control

Participants will receive 81mg daily of aspirin + placebo for 30 days.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

placebo

Aspirin 81Mg Ec Tab

Intervention Type DRUG

aspirin 81 milligrams

Intervention

Participants will receive 81mg of aspirin + rivaroxaban 2.5mg twice daily for 30 days.

Group Type EXPERIMENTAL

Rivaroxaban 2.5 Mg Oral Tablet

Intervention Type DRUG

rivaroxaban 2.5 milligrams twice daily

Aspirin 81Mg Ec Tab

Intervention Type DRUG

aspirin 81 milligrams

Interventions

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Rivaroxaban 2.5 Mg Oral Tablet

rivaroxaban 2.5 milligrams twice daily

Intervention Type DRUG

Placebo

placebo

Intervention Type DRUG

Aspirin 81Mg Ec Tab

aspirin 81 milligrams

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

History of peripheral artery disease (PAD) defined as:

* Previous aorto-femoral bypass surgery, limb bypass surgery, or percutaneous transluminal angioplasty revascularization of the iliac or infra-inguinal arteries, or
* Previous limb or foot amputation for arterial vascular disease, or
* An ankle/arm blood pressure (BP) ratio less than 0.90, or
* Significant peripheral artery stenosis (≥50%) documented by angiography, or by duplex ultrasound, or
* An ankle-brachial index (ABI) greater than 1.4 with a toe-brachial index (TBI) less than 0.7 AND
* Willing and able to provide written informed consent
* Receiving aspirin therapy prior to enrollment

Exclusion Criteria

* High risk of bleeding
* Stroke within 1 month of any history of hemorrhagic or lacunar stroke
* Severe heart failure with known ejection fraction less than 30% or New York Heart Association (NYHA) class III or IV symptoms
* Estimated glomerular filtration rate less than 15 mL/min/1.73m2
* Need for dual-antiplatelet therapy, other non-aspirin antiplatelet therapy, or oral anticoagulant therapy
* Known non-cardiovascular disease that is associated with poor prognosis (e.g. metastatic cancer) or that increases the risk of an adverse reaction to study interventions
* History of hypersensitivity or known contraindication to rivaroxaban or aspirin
* Systemic treatment with strong inhibitors of both CYP 3A4 and p-glycoprotein (e.g. systemic azole antimycotics, such as ketoconazole, and human immunodeficiency virus \[HIV\]-protease inhibitors, such as ritonavir), or strong inducers of CYP 3A4, i.e. rifampicin, rifabutin, phenobarbital, phenytoin, and carbamazepine
* Any known hepatic disease associated with coagulopathy
* Subjects who are pregnant, breastfeeding, or are of childbearing potential, and sexually active and not practicing an effective method of birth control (e.g. surgically sterile, prescription oral contraceptives, contraceptive injections, intrauterine device, double- barrier method, contraceptive patch, male partner sterilization)
* Concomitant participation in another study with investigational drug
* Upcoming invasive procedure within 3 months
* Invasive procedure within the prior 1 month
* Being treated for an active infection
* Acute or chronic limb-threatening ischemia
* Known contraindication to any study related procedures
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Aaron W. Aday, MD, MSc

Assistant Professor Division of Cardiovascular Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Aaron W Aday, MD

Role: PRINCIPAL_INVESTIGATOR

VUMC Cardiovascular Medicine

Locations

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

Other Identifiers

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5K23HL151871

Identifier Type: NIH

Identifier Source: secondary_id

View Link

200447

Identifier Type: -

Identifier Source: org_study_id