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Long term prognosis in patients with peripheral arterial disease treated with antiplatelet agents

N Fiotti1, N Altamura, C Cappelli

  • 1Unit of Internal Medicine, Department of Clinical, Morphological, and Technological Sciences, University of Trieste, Trieste, Italy.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|September 27, 2003
PubMed

Insights

Patients with peripheral artery disease (PAD) and intermittent claudication treated with antiplatelet agents still face higher mortality and non-fatal vascular events than controls. Cancer is the leading cause of death in these patients.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Oncology

Background:

  • Peripheral artery disease (PAD) with intermittent claudication is a significant health concern.
  • Antiplatelet agents are commonly prescribed to manage PAD, but their impact on long-term outcomes requires further investigation.

Purpose of the Study:

  • To evaluate the rate of fatal and non-fatal cardiovascular events in patients with intermittent claudication receiving antiplatelet therapy.
  • To compare these event rates with sex and age-matched controls.

Main Methods:

  • A cohort study involving 223 patients with PAD (Fontaine stage II) and 446 controls, followed from 1974 to 1998.
  • Patients received antiplatelet agents (aspirin or ticlopidine) and risk factor management.
  • Outcomes included all-cause mortality and non-fatal vascular events (myocardial infarction, stroke, amputation).

Main Results:

  • PAD patients exhibited a significantly higher mortality rate (3.99 vs. 2.53 deaths/100 patient-years) compared to controls, driven by vascular and cancer deaths.
  • The incidence of non-fatal vascular events was threefold higher in PAD patients (1.7 vs. 0.56/100 patient-years), including a higher rate of leg amputation.
  • No significant difference in outcomes was observed between aspirin and ticlopidine treatment groups.

Conclusions:

  • Despite antiplatelet therapy, patients with intermittent claudication experience increased vascular mortality and morbidity compared to controls.
  • Cancer emerges as the most frequent cause of death in this patient population.
  • Further strategies are needed to mitigate cardiovascular risks in PAD patients.
Abstract

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