The role of antiplatelet therapy in patients with peripheral artery disease and lower extremity peripheral artery revascularization

Abstract

Eligible patients with symptomatic PAD or with a history of peripheral artery revascularization should be prescribed antiplatelet monotherapy for secondary prevention of both cardiovascular and limb events, using aspirin, clopidogrel, and/or vorapaxar. Given the significant overlap of PAD and coronary artery disease, the evidence presented in this article may have important implications for management of patients with coronary artery disease.

The Current State of Critical Limb Ischemia

“…Dual antiplatelet therapy with aspirin and clopidogrel had a marginal benefit on reducing cardiovascular events in those with atherosclerotic disease, including the subset with PAD, at the expense of an increased risk of bleeding . Antiplatelet therapy had a favorable effect on limb-related events, with a 50% to 60% reduction of risk for arterial occlusion and graft patency …”

The prescribing of cardioprotective medications and the impact on survival for patients with peripheral artery disease that undergo intervention

“…Antiplatelet therapy was prescribed in 80% of patients and was associated with survival advantage. The reduction in risk of MACE with antiplatelets is well established 24 . Conversely, anticoagulation was associated with poorer survival.…”

“…The reduction in risk of MACE with antiplatelets is well established. 24 Conversely, anticoagulation was associated with poorer survival. Possibly the indication for anticoagulation contributes to the observed survival outcome.…”