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Antiplatelet therapy in peripheral arterial disease

Wilbert S Aronow1

  • 1Cardiology Division, Westchester Medical Center/New York Medical College, Valhalla, NY 10595, USA. WSAronow@aol.com

Current Drug Targets. Cardiovascular & Haematological Disorders
|September 24, 2004
PubMed

Insights

Antiplatelet therapy, including clopidogrel, is crucial for reducing vascular events in peripheral arterial disease (PAD) patients. The CAPRIE trial showed clopidogrel significantly outperformed aspirin in preventing major ischemic events in PAD.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Peripheral arterial disease (PAD) and associated conditions like intermittent claudication increase the risk of vascular death, myocardial infarction, and stroke.
  • Antiplatelet therapies are standard for managing these risks in patients with PAD, undergoing vascular procedures, or with carotid disease.

Purpose of the Study:

  • To evaluate the efficacy of different antiplatelet agents in patients with PAD.
  • To compare the effectiveness of clopidogrel versus aspirin in reducing ischemic events in a large PAD patient cohort.

Main Methods:

  • Systematic review of antiplatelet therapies for PAD.
  • Analysis of data from the Clopidogrel versus Aspirin in Patients at Risk for Ischaemic Events (CAPRIE) trial, involving 11,592 PAD patients.

Main Results:

  • Aspirin, aspirin plus dipyridamole, ticlodipine, and clopidogrel have demonstrated efficacy in PAD treatment.
  • The CAPRIE trial revealed that clopidogrel (75 mg daily) resulted in a significant 24% reduction in vascular death, nonfatal myocardial infarction, and nonfatal stroke compared to aspirin (325 mg daily).

Conclusions:

  • Clopidogrel is favored over aspirin for reducing vascular events in patients with PAD.
  • Antiplatelet therapy is essential for improving outcomes in patients with PAD and related vascular conditions.

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