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Mital Jhaveri: TRACK Trial Findings Highlight the Unique Challenges of Advanced CKD
Mital Jhaveri/LinkedIn
Jun 9, 2026, 15:18

Mital Jhaveri: TRACK Trial Findings Highlight the Unique Challenges of Advanced CKD

Mital Jhaveri, Clinical Anticoagulation, Heart Failure Pharmacist at NYC HHC Queens Hospital Center, shared on LinkedIn about a recent article by Sunil V. Badve, published in JAMA, adding:

”New in JAMA: The TRACK Trial examined the impact of low-dose rivaroxaban (2.5 mg BID) on major adverse cardiovascular events in patients with advanced chronic kidney disease (CKD) (Stage 4–5) at high cardiovascular risk.

The findings indicate no benefit and increased harm.

  • Primary composite cardiovascular outcome: 22.6% vs. 20.7% (HR 1.09; non-significant)
  • Major bleeding: significantly higher in the rivaroxaban arm (8.8%)
  • Trial halted early for futility

This study serves as a critical reminder that benefits established in the COMPASS and VOYAGER PAD trials do not apply to advanced CKD, a population with altered hemostatic and pharmacokinetic profiles.

As noted in the accompanying editorial, the TRACK trial should prompt a strategic pivot rather than an abandonment of the inquiry.

Bottom line: Low-dose rivaroxaban should not be used for primary cardiovascular protection in advanced CKD.”

Title: Low-Dose Rivaroxaban and Cardiovascular Events in Advanced Kidney Disease. The TRACK Randomized Clinical Trial

Authors: Sunil V. Badve, Vlado Perkovic, Vivekanand Jha, Raja Ramachandran, Lily Mushahar, Jan Menne, An S. De Vriese, Patrick Rossignol, Adrien Flahault, Maha Al Ammari, Habib Skhiri, Michael Walsh, David Collister, Adrian Liew, Laurent Billot, Severine Bompoint, Anthony Devaux, Min Jun, Enmoore Lin, Aline Ramos da Cruz, Jeffrey T. Ha, John W. Eikelboom, Ahmed Shaman, Meg J. Jardine, Shilpanjali Jesudason, Muh Geot Wong, Craig S. Anderson, Amit X. Garg, Hiddo J. L. Heerspink, Helen Monaghan, Anushka Patel, Patrick B. Mark, David C. Wheeler, Jicheng Lv, Li Zuo, Helen Pilmore, Martin Gallagher

Mital Jhaveri: TRACK Trial Findings Highlight the Unique Challenges of Advanced CKD

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Adrian Liew Adrien Flahault Ahmed Shaman Aline Ramos da Cruz Amit X. Garg An S. De Vriese Anthony Devaux Anushka Patel Chronic Kidney Disease CKD COMPASS Craig S. Anderson David C. Wheeler David Collister Enmoore Lin Habib Skhiri Helen Monaghan Helen Pilmore Hiddo J. L. Heerspink JAMA Jan Menne Jeffrey T. Ha Jicheng Lv John W. Eikelboom Laurent Billot Li Zuo Lily Mushahar Maha Al Ammari Martin Gallagher Meg J. Jardine Michael Walsh Min Jun Mital Jhaveri Muh Geot Wong Patrick B. Mark Patrick Rossignol Raja Ramachandran Rivaroxaban Severine Bompoint Shilpanjali Jesudason Sunil V. Badve TRACK Vivekanand Jha Vlado Perkovic VOYAGER PAD
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