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Antithrombotic strategies for patients with coronary and lower extremity peripheral artery diseases: a narrative

Leonardo De Luca1, Marc P Bonaca2, Giulia Magnani3

  • 1Department of Cardiosciences, A.O. San Camillo-Forlanini , Roma, Italy.

Expert Review of Cardiovascular Therapy
|October 6, 2020
PubMed

Insights

Optimal antithrombotic therapy for patients with both coronary artery disease (CAD) and peripheral artery disease (PAD) is crucial. Tailoring treatment intensity based on atherosclerotic burden improves cardiovascular outcomes in these high-risk individuals.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Patients with coexisting coronary artery disease (CAD) and peripheral artery disease (PAD) face high cardiovascular morbidity and mortality.
  • Antithrombotic therapies can reduce adverse cardiovascular events in CAD or PAD patients.
  • Optimal antithrombotic strategies for combined CAD and PAD are not well-established.

Purpose of the Study:

  • To review current data on antithrombotic therapies for patients with CAD and lower extremity PAD.
  • To provide insights into optimizing antithrombotic treatment in this high-risk population.

Main Methods:

  • Systematic review of existing literature.
  • Analysis of antithrombotic treatment regimens in CAD patients with concomitant lower extremity PAD.

Main Results:

  • Antithrombotic response in lower extremity PAD varies with atherosclerotic burden.
  • Less potent P2Y12 inhibitors like clopidogrel may suffice for isolated stable PAD.
  • Lower extremity PAD patients with documented CAD benefit from more intensive antithrombotic treatment.

Conclusions:

  • Treatment decisions for antithrombotic therapy in PAD patients should consider the extent of atherosclerosis.
  • A tailored approach to antithrombotic therapy is necessary for patients with combined CAD and PAD.
  • Further research is needed to define optimal antithrombotic regimens for this complex patient group.
Abstract

Keywords:
Antiplatelet therapyanticoagulation therapyaspirinclopidogrelcoronary artery diseasedual antiplatelet therapyperipheral artery diseaserivaroxabanticagrelorwarfarin

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