Vorapaxar is an antagonist of platelet protease-activated receptor (PAR-1) and also has an inhibitory effect on thrombin-induced platelet aggregation. In patients with a history of heart attack (MI) and peripheral vascular disease (PAD), treatment with Vorapaxar may reduce the incidence of thrombotic events. On the other hand, it is contraindicated in patients with a history of stroke because of its increased risk of intracranial hemorrhage. However, the incidence of new ischemic strokes and consequent death or intracranial hemorrhage in patients with MI or PAD without cerebrovascular disease (CVD) taking Vorapaxar is not known. For this reason, Marc P. Bonaca, MD, PhD, of Boston, USA, and colleagues conducted a study called “TRA2P-TIMI50”. The TRA2P-TIMI50 trial was a multi-country, randomized, double-blind, placebo-controlled trial that enrolled 26,449 patients with atherosclerosis who received Vorapaxar at a dose of 2.5 mg/day (graded by a combination of MI, PAD, or CVD) and enrolled 20,170 patients with MI and PAD but no CVD. PAD but no CVD. The results showed that Vorapaxar reduced the incidence of new ischemic strokes and that the incidence of hemorrhagic lesions following previous stroke and mortality did not increase significantly during the follow-up period in the Vorapaxar group. The incidence of hemorrhagic stroke was increased, but overall, the incidence of stroke was reduced. In conclusion, in patients with MI and PAD without CVD, Vorapaxar reduced the incidence of stroke and did not significantly increase the probability of post-stroke hemorrhagic lesions or death.