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 .
A Long-Term Study of Policosanol in the Treatment of Intermittent Claudication
Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects . This study was undertaken to investigate the long-term effects of policosanol administered to patients with moderately severe intermittent claudication . The study consisted of a 6-week single-blind , placebo-controlled run in phase , followed by a 2-year double-blind , r and omized treatment step . Fifty-six patients who met study entry criteria were r and omized to receive placebo or poli cosanol 10 mg twice daily . Walking distances on a treadmill ( constant speed 3.2 km/h , slope 10 ° , temperature 25 ° C ) were assessed before and after 6 , 12 , 18 , and 24 months of treatment . Both groups were similar at r and omization . After 6 months of therapy , policosanol significantly increased ( p < 0.0 1 ) the initial claudication distance from 125.9 ±8.7 m to 201.1 ±24.8 m and the absolute claudication distance from 219.5 ± 14.1 m to 380.7 ±50.2 m. Both variables remained unchanged in the placebo group ( p<0.01 ) . These effects did not wear off but improved after long-term therapy , so that final values were 333.5 ±28.6 m ( initial claudication distance ) and 648.9 ±54.1 m ( absolute claudication distance ) ; both significantly greater ( p<0.0001 ) than those obtained in the placebo group , which showed values of 137.9 ±21.8 m ( initial claudication distance ) and 237.7 ±28.1 m ( absolute claudication distance ) , respectively . At study completion , 21 policosanol and 5 placebo patients attained increases in claudication distance values > 50 % ( p < 0.001 ) . Policosanol , but not placebo , significantly increased the ankle/arm pressure index . In addition , from month 6 up to study completion , the frequency of patients reporting improve ment of lower limb symptoms was greater in the policosanol group than in the placebo group . The treatment was tolerated well . There were 16 withdrawals ( 12 placebo , 4 policosanol ) from the study . Eight patients in the placebo group experienced a total of 10 serious adverse events , 8 of which were vascular events , compared with none in the policosanol group ( p<0.01 ) . In addition , 3 patients in the policosanol group and 3 patients in the placebo group reported mild adverse events during the study . The present results demonstrate the long-term usefulness of policosanol therapy to treat patients with intermittent claudication
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 .