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VOYAGER-PAD Risk Reduction Index Calculator

  • Age (years)
  • Sex (1 = male, 0 = female)
  • Previous lower-extremity revascularization (1 = yes, 0 = no)
  • Baseline ankle-brachial index (ABI)
  • Surgical vs endovascular revascularization (1 = surgical, 0 = endovascular)
  • Target lesion length (cm)
  • VOYAGER-PAD Risk Reduction Index: Explanation and Clinical Context
    The VOYAGER-PAD Risk Reduction Index is a tool derived from the VOYAGER‑PAD Trial dataset, designed to estimate the three-year probability of a composite outcome (acute limb ischemia, major vascular amputation, myocardial infarction, ischemic stroke, or cardiovascular death) among patients undergoing lower-extremity revascularization for symptomatic peripheral artery disease (PAD). The primary trial enrolled 6,564 patients and demonstrated that dual-pathway inhibition with low-dose rivaroxaban plus aspirin significantly reduced the primary composite outcome compared with aspirin alone (HR 0.85; 95 % CI 0.76–0.96; absolute risk reduction ~2.6 % at 3 years). Patients at higher baseline risk (for example those with previous revascularization, ABI <0.50, surgical revascularization, longer lesion length) had greater event rates. By estimating individual risk, clinicians can better stratify patients who may derive higher absolute benefit from conservative, endovascular or surgical interventions and consider intensification of antithrombotic strategies or closer monitoring.

    Reference:
    Bonaca MP, et al. Rivaroxaban in Peripheral Artery Disease after Revascularization. N Engl J Med. 2020;382(21):1994-2004. doi:10.1056/NEJMoa2000052.

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