Antiplatelet agents have a beneficial effect in reducing all cause mortality and fatal cardiovascular events in patients with IC .
BACKGROUND Peripheral arterial disease ( PAD ) is common and is a marker of systemic atherosclerosis .
Patients with symptoms of intermittent claudication ( IC ) are at increased risk of cardiovascular events ( myocardial infa rct ion ( MI ) and stroke ) and of both cardiovascular and all cause mortality .
OBJECTIVES To determine the effectiveness of antiplatelet agents in reducing mortality ( all cause and cardiovascular ) and cardiovascular events in patients with intermittent claudication .
Impact of a 4-Week Treatment with Prostaglandin E1 on Health-Related Quality of Life of Patients with Intermittent Claudication
Intermittent claudication impairs functional status and quality of life in many patients by limiting walking capacity . The aim of this study was to evaluate the effects of a 4-week treatment with prostagl and in E1 ( PGE1 ) , a drug inducing vasodilation and inhibiting platelet aggregation , on improving functional status and health-related quality of life in patients with disabling intermittent claudication . Forty-two untrained out patients ( 37 men and five women , mean age 64 ±8 years ) with intermittent claudication , and maximum walking distance ( MWD ) of at least 50 and no more than 200 m on treadmill test ( 5 % slope , 3 km/hr ) were r and omized to 4 weeks of double-blind treatment either with 60 mcg PGE1 daily given IV in 250 mL saline over a period of 2 hours ( 21 patients ) or placebo ( 250 mL saline , 21 patients ) . Treatment-free follow-up was completed 8 weeks after the final infusion . Pain free walking distance ( PFWD ) , MWD , and question naire evaluation were determined at baseline , after the 4-week treatment period , and at the end of the 8 weeks of the treatment-free follow-up period . After 4 weeks of treatment with PGE1 PFWD and MWD increased from 72 ±16 m to 135 ±33 m ( + 87 % , p<0.001 ) and from 140 ±30 m to 266 ±62 m ( + 90 % , p<0.001 ) , respectively . Analysis of the Walking Impairment Question naire responses in the PGE1 group at 4 weeks demonstrated significant improvements in the walking impairment score ( + 19 percentage points , p<0.001 ) , in the distance score ( + 25 percentage points , p<0.001 ) , in the speed score ( + 24 percentage points , p<0.001 ) , in the stair climbing score ( + 20 percentage points , p < 0.001 ) . The R AND survey responses showed improvements in physical function and bodily pain scores ( + 14 percentage points , p<0.001 , and + 15 percentage points , p<0.01 , respectively ) . After the treatment-free follow-up period of 8 weeks , increases in PFWD and MWD were maintained ( 113 ±26 m , + 57 % , p<0.001 , and 229 ±55 m , + 63 % , p<0.001 , respectively ) . Similarly , at the end of the treatment-free follow-up , the walking impairment score ( + 16 percentage points , p<0.001 ) , the distance score ( + 23 percentage points , p<0.001 ) , the speed score ( + 22 percentage points , p<0.001 ) , the stair climbing score ( + 18 percentage points , p<0.001 ) as well as the R AND physical function and bodily pain scores ( + 10 percentage points , p<0.001 , and + 13 percentage points , p<0.01 , respectively ) were still increased compared with baseline . No change from baseline was found in all the target parameters in the placebo group after 4 weeks of treatment and at the end of the treatment-free follow-up period . These data show that a 4-week treatment with PGE1 improves functional status and quality of life as well as treadmill performance in patients with disabling intermittent claudication as compared with placebo-treated patients . The improvements are also maintained for a period of 8 weeks beyond the end of the treatment . Additional studies are needed to determine the duration of functional benefits after the end of treatment
Antiplatelet agents have a beneficial effect in reducing all cause mortality and fatal cardiovascular events in patients with IC .
BACKGROUND Peripheral arterial disease ( PAD ) is common and is a marker of systemic atherosclerosis .
Patients with symptoms of intermittent claudication ( IC ) are at increased risk of cardiovascular events ( myocardial infa rct ion ( MI ) and stroke ) and of both cardiovascular and all cause mortality .
OBJECTIVES To determine the effectiveness of antiplatelet agents in reducing mortality ( all cause and cardiovascular ) and cardiovascular events in patients with intermittent claudication .