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Antithrombotic therapy in peripheral artery disease: A review of the EUCLID trial results and current ongoing trials

Rachael Ward1, Chandler Long1,2, Manesh R Patel1,3

  • 1School of Medicine, Duke University Medical Center, Durham, North Carolina.

Clinical Cardiology
|January 23, 2018
PubMed

Insights

Ticagrelor offers no additional benefit over clopidogrel for patients with peripheral artery disease (PAD). This finding impacts antiplatelet therapy recommendations for reducing cardiovascular ischemic events in PAD patients.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Antithrombotic therapy is crucial for managing peripheral artery disease (PAD) to prevent ischemic events.
  • Current guidelines recommend aspirin or clopidogrel for long-term antiplatelet therapy in PAD patients.
  • Previous studies suggested potential benefits of ticagrelor over clopidogrel in patients with coronary artery disease and PAD.

Purpose of the Study:

  • To review the role of antiplatelet therapy in PAD management.
  • To analyze the results of the EUCLID trial comparing ticagrelor and clopidogrel in PAD.
  • To discuss factors influencing the interpretation of EUCLID trial findings and future research directions.

Main Methods:

  • Review of existing literature on antiplatelet therapy in PAD.
  • Analysis of the Examining Use of Ticagrelor in Peripheral Artery Disease (EUCLID) trial data.
  • Discussion of trial design considerations for the PAD population.

Main Results:

  • The EUCLID trial demonstrated no additional benefit of ticagrelor compared to clopidogrel in PAD patients.
  • A minority of patients in the EUCLID trial had concomitant coronary artery disease, differentiating it from prior studies.
  • The trial highlights the complexity of studying PAD and optimizing antithrombotic therapies.

Conclusions:

  • Ticagrelor is not superior to clopidogrel for preventing cardiovascular ischemic events in PAD.
  • Further meticulous trial design is needed to determine optimal antiplatelet strategies for PAD.
  • Ongoing clinical trials are exploring novel therapies for PAD treatment.

Keywords:
Antithrombotic TherapyAspirinClopidogrelPeripheral Artery DiseasePeripheral Vascular Intervention

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