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 .
Results of EMATAP: a double-blind placebo-controlled multicentre trial of ticlopidine in patients with peripheral arterial disease.
EMATAP , a r and omized stratified , placebo-controlled double-blind multicentre trial was performed in Argentina in order to confirm the effect of ticlopidine in the prevention of thrombotic events in patients with intermittent claudication . Twenty-one clinical centres enrolled 615 patients , 304 ( 88 diabetic and 216 non diabetic ) were assigned to the ticlopidine group and 311 ( 95 diabetic and 216 non diabetic ) to the placebo group . Treatments were given for 24 weeks . The baseline characteristics were identical in both groups . The compliance was good and only 34 patients ( 17 in each group ) did not reach the last visit . Their status however was checked and known at that time and according to the protocol , there was no patient lost to follow-up . Twenty-five patients experienced a first event during the follow-up period and the results show a very dramatic reduction of events in the ticlopidine group ( 5 vs 20 ) , the difference being highly significant ( p = 0.002 ) in intention-to-treat analysis . If we consider the subgrouping of outcome events : sudden deaths , myocardial infa rct ions and strokes on the one h and , vascular surgery on the other h and , a significant reduction is found in the ticlopidine group . Taking into account the total deaths plus non-fatal events ( 9 vs 21 ) , the results were also significant ( p = 0.027 ) . These above results therefore demonstrate a consistent reduction in all outcome events . As regard side effects there were fewer gastro-intestinal disturbances and skin reactions than seen in North American trials . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .