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Is there a role for oral anticoagulant therapy in patients with peripheral arterial disease?

B Cosmi1, G Palareti

  • 1Cardiovascular Department, Division of Angiology, S. Orsola-Malpighi University Hospital, Bologna, Italy.

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

Insights

For peripheral arterial disease (PAD), antiplatelet agents effectively reduce ischemic events. Oral anticoagulants offer limited benefit and increase bleeding risk, restricting their use in symptomatic PAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Pharmacology

Background:

  • Peripheral arterial disease (PAD) indicates systemic atherosclerosis and increases atherothrombotic risks.
  • Antiplatelet agents are established for reducing ischemic vascular complications in PAD.
  • Limited randomized trials exist comparing antiplatelet agents with oral anticoagulants in PAD.

Purpose of the Study:

  • To review the comparative effectiveness of antiplatelet agents versus oral anticoagulants in managing peripheral arterial disease.
  • To assess the role of oral anticoagulants in preventing vascular complications and their associated risks in PAD.

Main Methods:

  • Review of randomized controlled trials comparing antiplatelet agents and oral anticoagulants in PAD.
  • Analysis of data on efficacy in reducing ischemic events and incidence of bleeding.

Main Results:

  • Oral anticoagulants superior to aspirin only for preventing venous graft occlusion in high-risk infrainguinal bypass.
  • Effectiveness of oral anticoagulants for overall vascular morbidity and mortality reduction remains uncertain.
  • Increased bleeding risk is associated with oral anticoagulant use.

Conclusions:

  • Oral anticoagulants have a limited role in symptomatic PAD due to uncertain efficacy and increased bleeding risk.
  • Antiplatelet therapy remains a cornerstone for managing ischemic vascular complications in PAD.
  • Further research is needed to clarify the specific indications for oral anticoagulants in PAD management.

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