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Antiplatelet therapy to prevent cardiovascular events and mortality in patients with intermittent claudication

Peng Foo Wong1, Lee-Yee Chong, Gerard Stansby

  • 1Department of Vascular Surgery, James Cook University Hospital, Marton Road, Middlesbrough, Cleveland, TS4 3BW England. pwong23@hotmail.com

JAMA
|March 7, 2013
PubMed

Insights

Antiplatelet therapies significantly lower mortality for patients with intermittent claudication. Thienopyridines, like clopidogrel, offer the most robust protection against death from all causes and cardiovascular disease.

Area of Science:

  • Vascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Intermittent claudication is a common manifestation of peripheral artery disease.
  • Antiplatelet therapy is standard care, but optimal agent selection remains debated.

Purpose of the Study:

  • To evaluate the efficacy of antiplatelet therapies in reducing mortality and cardiovascular events in intermittent claudication patients.
  • To identify which antiplatelet agent provides the greatest mortality benefit.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Comparison of antiplatelet agents versus placebo for all-cause mortality, cardiovascular disease (CVD) mortality, and cardiovascular events.
  • Subgroup analysis to compare different classes of antiplatelet drugs.

Main Results:

  • Antiplatelet therapies significantly reduced all-cause mortality (RR 0.85, 95% CI 0.75-0.96) and CVD mortality (RR 0.78, 95% CI 0.65-0.93) compared to placebo.
  • Thienopyridines, particularly clopidogrel, demonstrated the strongest association with reduced all-cause and CVD mortality.

Conclusions:

  • Antiplatelet therapy is beneficial in managing intermittent claudication, reducing mortality risks.
  • Thienopyridines represent a preferred antiplatelet choice for patients with intermittent claudication due to superior mortality reduction.
Abstract

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