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 .
Reduction of requirement for leg vascular surgery during long-term treatment of claudicant patients with ticlopidine: results from the Swedish Ticlopidine Multicentre Study (STIMS).
OBJECTIVE To study the effect of long-term treatment of the platelet inhibitor ticlopidine as secondary prevention against the need of vascular surgery in patients with intermittent claudication . DESIGN The Swedish Ticlopidine Multicentre Study ( STIMS ) , was conducted in six medical and surgical clinics of university hospitals in Sweden . METHODS 687 claudicants were r and omised to ticlopidine 250 mg bd or placebo and vascular surgery events were recorded prospect ively over a 7-year period . Cox proportional hazards models of risk for leg vascular surgery were constructed using drug treatment and 11 putative risk factors for vascular disease as covariates . Surgical event-free survivals were compared by Kaplan-Meier analysis . RESULTS The overall rate of first operations was 2.4 % per annum . More than half of these operations were in the aortoiliac region . One-quarter of patients operated during the period required further operations but amputation was rare . Ticlopidine treatment reduced the need for vascular reconstructive surgery by about half , both in intention-to-treat and on-treatment analyses ( unadjusted relative risks 0.486 , 95 % CI 0.317 - 0.745 ; p < 0.001 ; 0.493 , 95 % CI 0.290 - 0.841 : p < 0.01 , respectively ) . In Cox model analysis only male sex was confirmed as a risk factor for surgery . Previous peripheral arterial surgery was the strongest predictor of the need for surgery . None of the risk factors examined interacted statistically with the effect of treatment with ticlopidine . CONCLUSION In patients with intermittent claudication it seems possible to prevent the need for future vascular surgery by the use of platelet inhibition with ticlopidine
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 .