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 .
Effects of Policosanol and Lovastatin in Patients with Intermittent Claudication: A Double-Blind Comparative Pilot Study
Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects . The present study was undertaken to compare the effects of policosanol and lovastatin on patients with moderately severe intermittent claudication . The study had a 4-week baseline step , followed by a 20-week double blinded , r and omized treatment period . Twenty-eight patients who met study entry criteria were r and omized to policosanol 10 mg or lovastatin 20 mg tablets once daily  . 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 r and om ization . Compared with baseline , policosanol increased significantly ( p<0.01 ) the initial claudi cation distance ( ICD ) from 160.39 ±15.82 m to 211.31 ±21.48 m ( + 33.7 % ) and the absolute claudication distance ( ACD ) ( p<0.001 ) from 236.39 ±25.44 m to 288.09 ±28.47 m ( + 24.3 % ) ; meanwhile both variables remained unchanged after lovastatin  therapy . Changes in ICD and ACD were significantly larger in the policosanol than in the lovastatin group ( p<0.01 ) . Policosanol , but not lovastatin , significantly increased ( p < 0.05 ) the ankle/arm index , although between-group differences were not significant . The frequency of patients reporting improve ment on quality of life domains was greater in the policosanol than in the lovastatin group . Policosanol significantly ( p < 0.00 1 ) lowered total cholesterol ( TC ) and low-density lipoprotein- cholesterol ( LDL-C ) by 17.5 % and 31.0 % , respectively , and meanwhile increased ( p<0.01 ) high- density lipoprotein-cholesterol ( HDL-C ) levels by 31.5 % . Lovastatin  reduced ( p<0.01 ) TC ( 18.0 % ) , LDL-C ( 22.6 % ) , and ( p<0.05 ) triglycerides ( 9.8 % ) . In addition , policosanol , but not lovastatin , moderately , but significantly , reduced ( p < 0.05 ) fibrinogen levels , so that final values and percent changes in both groups were different ( p<0.01 ) . Treatments were well tolerated . Only 1 lovastatin patient withdrew from the study because of a nonfatal myocardial infa rct ion . Five lovastatin patients , but none from the policosanol group , experienced 6 adverse events ( AE ) ( p<0.01 ) . The present results indicate that policosanol , but not lovastatin , is a suitable alternative to manage patients with intermittent claudication  because of pleiotropic properties beyond its cholesterol-lowering effects
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 .