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 .
Effect of cloricromene on intermittent claudication. A randomized, double-blind, placebo-controlled trial in patients treated with aspirin: effect on claudication distance and quality of life
The main aim of medical treatment for intermittent claudication ( IC ) is the reduction of mortality and morbidity from ischemic cardiovascular disease . However , symptomatic treatment with the aim of improving exercise performance and the overall quality of life may also be an important target of the clinical management of patients with intermittent claudication .  Cloricromene , a drug with antithrombotic and anti-ischemic activities , has previously shown some promising results in patients with claudication . We have carried out a clinical trial to assess the effect of cloricromene on the claudication distance and on the quality of life of patients with IC chronically treated with aspirin . A total of 159 patients with IC , Stage II ( Fontaine ) , were enrolled in a double-blind , r and omized , prospect i ve , multicenter study comparing cloricromene ( 100 mg orally b.i.d . ) or an identical placebo for 6 months . All patients received 160 mg/day aspirin . The primary end-point was the improvement of initial claudication distance ( ICD ) at 6 months as measured by a st and ardized treadmill test . The secondary end-points were the absolute claudication distance ( ACD ) at 6 months , the percentage of patients defined as responders to treatment ( improvement of ICD of at least 40 % ) , changes in the ischemic window ( IW ) , quality of life as assessed by the SF-36 question naire , and the occurrence of major cardiovascular events . The ICD increased in both treatment groups , with a non-significant difference at 6 months in favor of cloricromene of + 12.3 m. The ACD , percentage of responders to treatment and ischemic window also improved in both groups with a slight , non-significant trend in favor of cloricromene . Pretreatment quality of life scores showed only a slight worsening compared with an age-matched , healthy population and did not change upon treatment . A post hoc subgroup analysis showed a significant benefit from cloricromene in patients with an ICD at enrollment higher than the median of the patient population . In conclusion , treatment with cloricromene for 6 months does not significantly improve  claudication in patients with Stage II Fontaine peripheral arteriopathy chronically treated with aspirin . An improvement of 40 - 60 m in the ICD on a st and ardized treadmill test does not translate into a self-perceived improvement in the quality of life as assessed by the SF-36 question naire
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 .