Rationale for the use of platelet aggregation inhibitors in PAD patients

被引:2
作者
Agnelli, G [1 ]
机构
[1] Univ Perugia, Dept Internal Med, Div Internal & Cardiovasc Med, I-06123 Perugia, Italy
关键词
atherothrombosis; peripheral arterial disease;
D O I
10.1177/1358836X0100600i104
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Peripheral arterial disease (PAD) is a major risk marker for systemic ischaemic events. The understanding of PAD has moved from PAD as an organ-specific disease to PAD as the lower-limb localization of a multifocal disease, i.e. atherothrombosis. Blood platelet activation and aggregation is a common denominator in atherothrombotic events, and use of antiplatelet agents in patients with PAD can inhibit thrombus formation and reduce the occurrence of myocardial infarction (MI), ischaemic stroke (IS) and vascular death. Many studies have investigated various antiplatelet regimens for preventing acute cardiovascular events in patients with a prior ischaemic event, although many of these studies had a number of limitations. The Antiplatelet Trialists' Collaboration performed a meta-analysis of 23 stroke trials and found an average odds risk reduction of 25% for a combined endpoint of stroke, MI or vascular death. The concept of atherothrombosis as a multifocal disease was challenged by the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events (CAPRIE) trial. This study showed an 8.7 lo decrease in the relative risk reduction for further atherothrombotic events with clopidogrel over aspirin (p=0.043) for the overall population, in terms of the combined endpoint of IS, MI or vascular death.
引用
收藏
页码:13 / 15
页数:3
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