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 .
Peripheral artery occlusion: treatment with abciximab plus urokinase versus with urokinase alone--a randomized pilot trial (the PROMPT Study). Platelet Receptor Antibodies in Order to Manage Peripheral Artery Thrombosis.
PURPOSE To evaluate the combination of a platelet glycoprotein IIb/IIIa complex receptor inhibitor and urokinase for treatment of recent ( < or=6 weeks ) arterial occlusion of the legs . MATERIAL S AND METHODS Seventy patients with lower extremity arterial occlusion of less than 6 weeks duration were r and omly separated into two treatment groups : urokinase plus abciximab or urokinase plus placebo . Primary end points were the rate of major complications at 30 days after r and omization and the rates of amputation-free survival and survival without open surgery or major amputation at follow-up of 90 days . Two readers unaware of the patients ' treatment group assignments analyzed digital subtraction angiograms as they related to the study end points , with a final consensus reading . RESULTS Thrombolysis relative to clot length was faster in the urokinase-plus-abciximab group ( odds ratio , 0.52 ; 95 % CI : 0.35 , 0.76 ; P < .001 ) . There were no procedure-related deaths or intracranial hemorrhages , but the rate of nonfatal major bleeding was higher with urokinase plus abciximab ( four of 50 patients ) than with urokinase alone ( none of 20 patients ; P = .32 ) . At 90 days , amputation-free survival was 96 % ( 48 of 50 patients ) in the urokinase-plus-abciximab group compared with 80 % ( 16 of 20 patients ) in the urokinase alone group . The hazard ratio for the two Kaplan-Meier curves was 0.42 ( 95 % CI : 0.16 , 0.96 ; P = .04 ) . CONCLUSION In patients with lower extremity arterial occlusion who were undergoing urokinase thrombolysis  , adjunctive abciximab treatment result ed in faster thrombus dissolution and improved amputation-free survival , despite an increase in major bleeding
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 .