Heart. Published Online First: 11 October 2006. doi:10.1136/hrt.2006.102350
Original articles |
Antithrombotic therapy for peripheral arterial disease
1 Institute for Clinical Evaluative Siences, Canada
2 McMaster University, Canada
* To whom correspondence should be addressed. E-mail: danhackam{at}cogeco.ca.
Accepted 20 September 2006
Abstract
Patients with peripheral arterial disease bear a substantial risk for vascular events in the coronary, cerebral, and peripheral circulations. In addition, this disorder is associated with a systemic milieu characterized by ongoing platelet activation and heightened thrombogenesis; this milieu has been linked to subsequent cardiovascular events. These considerations suggest that some form of antithrombotic prophylaxis, consisting of either an antiplatelet or oral anticoagulant regimen, should be used in all patients with peripheral arterial disease. However, which agent to use has been a source of uncertainty, as evidence from randomized trials, meta-analyses and cost-benefit studies have often favored different approaches. This article synthesizes the available evidence and suggests that aspirin should remain the cornerstone of antithrombotic therapy for most patients with peripheral arterial disease.
Keywords: anticoagulants, antiplatelets, peripheral arterial disease, prevention, thrombosis
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