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 .
The STIMS Trial: The Ticlopidine Experience and its Clinical Applications
The mortality in patients with intermittent claudication can be reduced by treatment with ticlopidine . This is the clinical ly most significant result from STIMS , the Swedish Ticlopidine Multicenter Study . During an average treatment period of 5.6 years , 153 of the 687 patients  died , 26.1 % in the placebo group and 18.5 % in the ticlopidine group ( RR0.7 , p=0.015 ) . The incidence of fatal vascular events in the two groups was 12 % and 6 % . In terms of lives saved per years of treatment , STIMS showed that by treating 200 claudicants for 5 years one can save 13 from a cardiovascular death , not merely dying from something else as treatment was associated with a reduced total mortality as well . The interpretation of the on-treatment analysis is that for those who tolerate the drug the combined vascular morbidity and mortality rate is lowered from 24 % to 14 % . The disadvantage is that many patients do not tolerate ticlopidine . In STIMS , 22 % ( 2.5 times as many as in the control group ) had to stop medication because of gastrointestinal side-effects . Although ticlopidine is associated with an increased risk of leukopenia , the risk in absolute numbers is small : according to STIMS , 4 % during 5.6 years . All events were reversible . The 1.4 % incidence of thrombocytopenia did not seem to be associated with ticlopidine treatment
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 .