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 .
Clopidogrel has no effect on D-dimer and thrombin-antithrombin III levels in patients with peripheral arterial disease undergoing peripheral percutaneous transluminal angioplasty.
OBJECTIVE Coagulation activation markers are significantly elevated in patients with peripheral arterial disease compared with healthy controls . The more severe the disease , the higher the markers . Increased coagulation activation may contribute to the disease process and the risk of complications in patients with peripheral arterial disease , particularly after endovascular intervention . Animal studies have shown that clopidogrel significantly inhibits coagulation activation . The aim of this study was to determine whether combination of aspirin and clopidogrel affects thrombin-antithrombin III and D-dimer in patients with intermittent claudication undergoing angioplasty , compared with aspirin alone . METHODS This was a double blind , r and omized placebo-controlled trial conducted in a vascular unit in a tertiary referral center . One hundred thirty-two patients with intermittent claudication were r and omized to clopidogrel and aspirin or placebo and aspirin , with a loading dose 12 hours before endovascular intervention . D-dimer and thrombin-antithrombin III ( TAT ) levels were measured using enzyme-linked immunosorbent assay at baseline , 1 hour before , and 1 hour , 24 hours , and 30 days after intervention in 103 patients who underwent endovascular intervention . RESULTS There was a significant rise in D-dimer levels at 1 hour and 24 hours after angioplasty in both groups ( placebo group : 63.69 , 141.45 , 122.18 ng/mL ; clopidogrel group : 103.79 , 159.95 , 134.69 ng/mL ) , but no difference between the two groups ( P = .514 ) . Similarly there was a significant rise in TAT levels at 1 hour after angioplasty in both groups ( placebo group : 2.93 , 6.16 microg/L ; clopidogrel group : 3.39 , 5.27 microg/L ) , with no significant difference between the two groups ( P = .746 ) . CONCLUSION Endovascular intervention results in a significant increase in TAT and D-dimer . The addition of clopidogrel to aspirin has no effect on TAT and D-dimer before or after endovascular intervention
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 .