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Prophylactic Antiplatelet Therapy in Peripheral Arterial Disease

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Summary

Prophylactic therapy with antiplatelet drugs aims to improve both the general prognosis of patients and the local progression of peripheral arterial disease. A recent meta-analysis of 28 trials revealed that the proportional risk reduction in serious vascular events is similar to that in cardio- and cerebrovascular disease. A decreased incidence of vascular complications was also found in a meta-analysis of 4 trials with ticlopidine, and a recent Swedish study [Swedish Ticlopidine Multicentre Study (STIMS)] confirmed that long term ticlopidine reduces both mortality and cardio- and cerebrovascular morbidity.

There is also evidence that aspirin (acetylsalicylic acid) and ticlopidine retard progression of atherosclerosis and the occurrence of its thrombotic complications, in patients with arterial disease of the legs.

Meta-analysis has recently indicated that antiplatelet agents reduce the incidence of graft occlusion in arterial surgery. These drugs are also traditionally prescribed after percutaneous revascularisation procedures. The efficacy of antiplatelet therapy in patients with peripheral arterial disease emphasises the role of platelets in this condition.

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References

  • Antiplatelet Trialists’ Collaboration. Secondary prevention of vascular disease by prolonged antiplatelet treatment. British Medical Journal 296: 320–333, 1988

    Article  Google Scholar 

  • Antiplatelet Trialists’ Collaboration. Final report of the second cycle. Submitted for publication, 1991

  • Arcan JC, Panak E. Ticlopidine in the treatment of peripheral occlusive arterial disease. Seminars in Thrombosis and Haemostasis 15: 167–170, 1989

    Article  CAS  Google Scholar 

  • Balsano F, Coccheri S, Libretti A, Nenci GG, Catalano M, et al. Ticlopidine in the treatment of intermittent claudication: a 21-month double blind trial. Journal of Laboratory and Clinical Medicine 114: 84–91, 1989

    PubMed  CAS  Google Scholar 

  • Boissel JP, Peyrieux JC, Destors JM. Is it possible to reduce the risk of cardiovascular events in subjects suffering from intermittent claudication of the lower limbs? Thrombosis and Haemostasis 62: 681–685, 1989

    PubMed  CAS  Google Scholar 

  • Bollinger A, Brunner U. Antiplatelet drugs improve the patency rates after femoropopliteal endarterectomy. Vasa 14: 272–279, 1985

    PubMed  CAS  Google Scholar 

  • Clagett GP, Genton E, Salzman EW. Antithrombotic therapy in peripheral vascular tissue. Chest 95: 128S–139S, 1989

    PubMed  CAS  Google Scholar 

  • Clyne CAC, Archer TJ, Atuhaire LK, Chant ADB, Webster JHH. Random control trial of a short course of aspirin and dipyridamole (Persantin) for femorodistal grafts. British Journal of Surgery 74: 246–248, 1987

    Article  PubMed  CAS  Google Scholar 

  • Dormandy J, Mahir M, Ascády G, Balsano F, De Leeuw P, et al. Fate of the patient with chronic leg ischemia. A review article. Journal of Cardiovascular Surgery 30: 55–57, 1989

    Google Scholar 

  • Duffield RG, Lewis B, Miller NE, Jamieson CW, Brunt JN, et al. Treatment of hyperlipidaemia retards progression of symptomatic femoral atherosclerosis. Lancet 2: 639–642, 1983

    Article  PubMed  CAS  Google Scholar 

  • Genton E, Clagett GP, Salzman EW. Antithrombotic therapy in peripheral vascular disease. Archives of Internal Medicine 146: 470–471, 1986

    Google Scholar 

  • Goldman M, McCollum C. A prospective randomized study to examine the effect of aspirin plus dipyridamole on the patency of prosthetic femoro-popliteal grafts. Vascular Surgery 18: 217–221, 1984

    Article  Google Scholar 

  • Green RM, Roederscheimer R, De Weese JA. Effects of aspirin and dipyridamole on expanded polytetrafluoroethylene graft patency. Surgery 82: 1016–1026, 1982

    Google Scholar 

  • Hess H, Mietaschk A, Deichsel G. Drug-induced inhibition of platelet function delays progression of peripheral occlusive arterial disease. A prospective double-blind arteriographically controlled trial. Lancet 1: 415–419, 1985

    Article  PubMed  CAS  Google Scholar 

  • Janzon L, Bergqvist D, Boberg J, Boberg M, Eriksson I, et al. Prevention of myocardial infarction and stroke in patients with intermittent claudication; effects of ticlopidine. Results from STIMS, the Swedish Ticlopidine Multicentre Study. Journal of Internal Medicine 227: 301–308, 1990

    Article  PubMed  CAS  Google Scholar 

  • Kohler TR, Kaufman JL, Kacoyanis G, Clowes A, Donaldson MC, et al. Effect of aspirin and dipyridamole on the patency of lower extremity bypass grafts. Surgery 96: 462–466, 1984

    PubMed  CAS  Google Scholar 

  • Larsen OA, Lassen NA. Effect of daily muscular exercise in patients with intermittent claudication. Lancet 2: 1093–1096, 1966

    Article  PubMed  CAS  Google Scholar 

  • Nevelsteen A, Mortelmans L, Van de Cruys A, Merckx E, Verhaeghe R. Effect of ticlopidine on blood loss, platelet turnover and platelet deposition on prosthetic surfaces in patients undergoing aorto-femoral bypass grafting. Thrombosis Research, in press

  • Palareti G, Poggi M, Torricelli P, Balestra V, Coccheri S. Long-term effects of ticlopidine on fibrinogen and haemorheology in patients with peripheral arterial disease. Thrombosis Research 52: 621–629, 1988

    Article  PubMed  CAS  Google Scholar 

  • Prevention of Atherosclerotic Complications with Ketanserin Trial Group. Prevention of atherosclerotic complications: controlled trial with ketanserin. British Medical Journal 298: 424–430, 1989

    Article  Google Scholar 

  • Quick CGR, Cotton LT. The measured effect of stopping smoking on intermittent claudication. British Journal of Surgery 69 (Suppl.): 24–26, 1982

    Article  Google Scholar 

  • Schoop W, Levy H, Schoop B, Gaentsch A. Experimentelle und klinische Studien zu der sekundären Prävention der peripheren Arteriosklerose. In Bollinger A, Rhyner K (Eds) Thrombozytenfunktionshemmer, pp. 49–58, George Thieme Verlag, Stuttgart, 1983

    Google Scholar 

  • Shionoya S, Sakurai T. Influence de la ticlopidine sur les résultats de la chirurgie artérielle reconstructive périphérique: étude prospective multicentrique de 3 ans. Sang, Thrombose, Vaisseaux 2 (Suppl.): 12–16, 1990

    Google Scholar 

  • Stiegler H, Hess H, Mietaschk A, Tramppisch HJ, Ingrisch H. Einfluss von Ticlopidin auf die perifere obliterierende Arteriopathie. Deutsche Medizinische Wochenschrift 109: 1240–1243, 1984

    Article  PubMed  CAS  Google Scholar 

  • Verhaeghe R, Bounameaux H. Peripheral arterial occlusion: thromboembolism, antithrombotic and thrombolytic therapy. In Fuster V, Verstraete M (Eds) Thrombosis in Cardiovascular Diseases, W.B. Saunders Company, Orlando, in press, 1991

    Google Scholar 

  • Zeitler E, Reichold J, Schoop W, Loew D. Einfluss von Acetylsalicylsäure auf das Frühergebnis nach perkutaner Rekanalisation obliterierter Arterien mit der Kathetermethode. Deutsche Medizinische Wochenschrift 98: 1285–1288, 1973

    Article  PubMed  CAS  Google Scholar 

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Verhaeghe, R. Prophylactic Antiplatelet Therapy in Peripheral Arterial Disease. Drugs 42 (Suppl 5), 51–57 (1991). https://doi.org/10.2165/00003495-199100425-00008

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