Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .
Effects of Policosanol and Ticlopidine in Patients with Intermittent Claudication: A Double-Blinded Pilot Comparative Study
Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects . The present study was undertaken to compare the effects of policosanol and ticlopidine in patients with moderately severe intermittent claudication ( IC ) . The study had a 4-week baseline step , followed by a 20-week double-blinded , r and omized treatment period . Twenty-eight eligible patients were r and omized to  policosanol 10 mg  or ticlopidine  250 mg tablets twice daily ( bid ) . Walking distances in a treadmill ( constant speed 3.2 km/hr , slope 10 ° , temperature 25 ° C ) were assessed before and after 20 weeks of treatment . Both groups were similar at baseline . Compared with baseline , policosanol significantly increased ( p<0.01 ) mean values of initial ( ICD ) and absolute ( ACD ) claudication distances from 162.1 to 273.2 m and from 255.8 to 401.0 m , respectively . Ticlopidine also raised significantly ( p<0.01 ) ICD ( 166.2 to 266.3 m ) and ACD ( 252.9 to 386.4 m ) . Comparisons between groups did not show significant differences . Policosanol , but not ticlopidine , significantly ( p<0.05 ) , but modestly , increased the ankle/arm pressure ratio . After 10 weeks , policosanol significantly ( p<0.001 ) lowered low-density lipoprotein-cholesterol ( LDL-C ) , total cholesterol ( TC ) ( p<0.01 ) , and TC/HDL-C and raised ( p<0.05 ) high-density lipoprotein-cholesterol ( HDL-C ) . At study completion , policosanol  lowered ( p<0.001 ) LDL-C ( 30.2 % ) , TC ( 16.9 % ) , and TC/HDL-C ( 33.9 % ) , increased ( p<0.01 ) HDL-C ( + 31.7 % ) , and left triglycerides  unchanged . Ticlopidine did not affect the lipid profile variable . Policosanol induced modest , but significant , reductions ( p<0.01 ) of fibrinogen levels compared with baseline and ticlopidine . Treatments were well tolerated and did not impair safety indicators .  Three ticlopidine patients ( 21.4 % ) withdrew from the trial , only 1 owing to a serious adverse experience ( AE ) ( unstable angina ) . Three other ticlopidine patients experienced mild AE ( headache , diarrhea , and acidity ) . It is concluded that policosanol ( 10 mg bid ) can be as effective as ticlopidine ( 250 mg bid ) for improving walking distances of claudicant patients , and it could be advantageous for the global risk of these individuals owing to its cholesterol-lowering effects . This study is , however , just a pilot comparison , so that further studies in larger sample sizes are needed for definitive conclusions of the comparative effects of both drugs on patients with IC
Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .