Aortic & peripheral vascular disease
Effect of low-dose rivaroxaban plus aspirin on 18F-FDG PET/CT-detectable carotid plaque inflammation: a randomized trial
Primary result · Per cent change in the most diseased segment (MDS) TBR of the index carotid arteryAdjusted between-group difference −1.50 percentage points 95% CI −6.20 to 3.21- single-centre, randomized, open-label, proof-of-concept trial with blinded endpoint assessment
Authors' conclusion
In patients with carotid atherosclerosis, adding low-dose rivaroxaban to aspirin did not produce a detectable incremental reduction in 18F-FDG PET/CT-assessed carotid plaque inflammation compared with aspirin alone over 12 months.
Study context
- Population
- Adults with asymptomatic carotid stenosis (20–80%) and elevated carotid FDG uptake (TBR ≥ 1.6)randomized, 81 (88%) completed paired imaging
- Participants
- 92 adults
- Comparison
- aspirin plus rivaroxaban or aspirin alone
- Primary endpoint
- Per cent change in the most diseased segment (MDS) TBR of the index carotid artery
- Follow-up
- 12 months
Primary result
As reported in the abstract
Per cent change in the most diseased segment (MDS) TBR of the index carotid artery
Adjusted between-group difference
−1.50 percentage points
95% CI −6.20 to 3.21
P = 0.529
By group
combination therapy
−7.25%
mean per cent change · 95% CI −11.03–-3.48
aspirin alone
−7.36%
mean per cent change · 95% CI −11.06–-3.67
combination therapy vs aspirin alone
adjusted between-group difference −1.50 percentage points (95% CI −6.20 to 3.21); P = 0.529
Secondary outcomes
Secondary imaging endpoints
- Secondary imaging endpoints were concordant
Laboratory parameters
- Laboratory parameters were similar, except for a nominal high-sensitivity C-reactive protein (hsCRP) difference
- without multiplicity adjustment
Safety
Minor bleeding
Minor bleeding
- Minor bleeding occurred in four (8.7%) patients with combination therapy and one (2.2%) patient with aspirin alone; no major bleeding or deaths occurred
Original publication
Effect of low-dose rivaroxaban plus aspirin on 18F-FDG PET/CT-detectable carotid plaque inflammation: a randomized trial. Eur Heart J Cardiovasc Imaging. Published 13 July 2026. doi:10.1093/ehjci/jeag176
Summarised from the published abstract; every number is checked against it