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 .
Thrombin and platelet inhibition with low-dose calcium-heparin in comparison with ASA in patients with peripheral arterial occlusive disease at Leriche-Fontaine IIb class.
Sixty patients with a mean age of 64 years ( range 57 - 77 years ) , 55 males and 5 females , with peripheral arterial occlusive disease ( PAOD ) at Leriche-Fontaine IIb class were r and omly allocated to receive either subcutaneous calcium-heparin ( 12,500 IU once daily ) or oral acetylsalicylic acid ( ASA ) ( 300 mg twice daily ) , each given for 3 months , followed by a 6-month follow-up period during which no treatment was given . The following parameters were evaluated before r and omization , after 1 and 3 months of therapy and after 1 , 3 and 6 months of follow-up : pain-free walking distance ( PWD ) , maximum walking distance ( WDmax ) , systolic and diastolic blood pressure , posterior tibial arterial pressure and ankle/arm index at rest and after exercise ( treadmill ) , transcutaneous gas analysis at rest ( TcPO2 ) . Under both treatments a statistically significant increase ( p < 0.01 ) in PWD/WDmax was observed after 3 months of therapy . Calcium-heparin was slightly but significantly more effective than ASA in prolonging WDmax ( p < 0.05 ) after 3 months of therapy . Both treatment groups maintained the clinical improvement after 6 months of follow-up without any difference between each-other . Both treatments result ed in a statistically significant increase in TcPO2 and decrease in plasma fibrinogen but under calcium-heparin treatment these modifications were doubled in comparison with ASA ( p < 0.01 and p < 0.05 , respectively for TcPO2 and fibrinogen ) . The sustained effects on these parameters after 6 months of follow-up could suggest a more direct and multifactorial activity of calcium-heparin on microcirculation . ( 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 .