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Efficacy of aspirin for secondary prevention in patients with peripheral artery disease

Dmitriy N Feldman1, Issam D Moussa

  • 1Greenberg Division of Cardiology, New York Presbyterian Hospital, Weill Cornell Medical College, Greenberg Division of Cardiology, Starr-434 Pavilion, NY 10021, USA.

Expert Review of Cardiovascular Therapy
|October 10, 2009
PubMed

Insights

Aspirin did not significantly reduce cardiovascular events in peripheral artery disease (PAD) patients, but it did lower stroke incidence. Further research is needed on optimal antiplatelet therapy for PAD.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Trials
  • Pharmacology

Background:

  • Current guidelines suggest low-dose aspirin for secondary cardiovascular event prevention in peripheral artery disease (PAD) patients.
  • The efficacy of aspirin in PAD patients has been debated due to limited conclusive evidence.
  • This meta-analysis evaluates aspirin's impact on cardiovascular events in individuals with PAD.

Discussion:

  • A meta-analysis of 18 trials examined aspirin's effect on nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death in PAD patients.
  • Results indicated that aspirin did not significantly decrease the composite endpoint of cardiovascular events.
  • A significant reduction in nonfatal stroke incidence was observed with aspirin treatment.

Key Insights:

  • Aspirin's overall efficacy in preventing combined cardiovascular events in PAD is not statistically significant.
  • Aspirin demonstrated a significant benefit in reducing the risk of nonfatal stroke in the PAD population.
  • The findings challenge the universal recommendation of aspirin for all PAD patients.

Outlook:

  • Further investigation is warranted to determine the optimal antiplatelet strategy for PAD patients.
  • The study prompts consideration of alternative or combination therapies, such as clopidogrel.
  • Future research should focus on personalized antiplatelet approaches based on individual patient risk profiles.

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