Biomaterial Database

Antiplatelet therapy in peripheral occlusive arterial disease. 2006

Shen Wong, and Michael Appleberg, and David R Lewis

Department of Vascular Surgery, Sydney University, The Royal North Shore Hospital, Sydney, New South Wales, Australia.

BACKGROUND Antiplatelet therapy (APT) in patients with peripheral occlusive arterial disease (POAD) may reduce cardiovascular (CV) morbidity and mortality by inhibiting atherothrombosis. This article reviews the current evidence for APT in patients with stable POAD and in patients undergoing revascularization procedures for POAD. METHODS A Medline and Pubmed literature search (January 1966 to February 2003) was conducted to identify articles relating APT and POAD. Manual cross referencing was also used. CONCLUSIONS Meta-analyses suggest that APT (most commonly aspirin) in patients with stable POAD significantly reduces the incidence of nonfatal stroke, myocardial infarction and CV death. However, this conclusion is based on subset analysis of data predominantly involving patients with coronary and cerebrovascular atherosclerosis. There is a little direct evidence for the use of aspirin in patients with isolated POAD, but in practice, aspirin remains the most commonly used antiplatelet agent as high rates of coronary and cerebrovascular diseases are observed in this patient population. For patients with POAD without additional indicators of vascular risk, the protective effect of aspirin is unclear and dependent on the balance of risks and benefits in the individual patient. For patients undergoing peripheral revascularization, ticlopidine and aspirin in combination with dipyridamole are effective in maintaining patency after bypass procedures and following angioplasty/femoral endarterectomy. The efficacy of thienopyridines in peripheral angioplasty is uncertain, and the optimum timing and duration of APT relative to intervention are not known.

UI	MeSH Term	Description	Entries
D010975	Platelet Aggregation Inhibitors	Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.	Antiaggregants, Platelet,Antiplatelet Agent,Antiplatelet Agents,Antiplatelet Drug,Blood Platelet Aggregation Inhibitor,Blood Platelet Antagonist,Blood Platelet Antiaggregant,PAR-1 Antagonists,Platelet Aggregation Inhibitor,Platelet Antagonist,Platelet Antagonists,Platelet Antiaggregant,Platelet Antiaggregants,Platelet Inhibitor,Protease-Activated Receptor-1 Antagonists,Antiplatelet Drugs,Blood Platelet Aggregation Inhibitors,Blood Platelet Antagonists,Blood Platelet Antiaggregants,Platelet Inhibitors,Agent, Antiplatelet,Aggregation Inhibitor, Platelet,Antagonist, Blood Platelet,Antagonist, Platelet,Antiaggregant, Blood Platelet,Antiaggregant, Platelet,Drug, Antiplatelet,Inhibitor, Platelet,Inhibitor, Platelet Aggregation,PAR 1 Antagonists,Platelet Antagonist, Blood,Platelet Antiaggregant, Blood,Protease Activated Receptor 1 Antagonists
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001157	Arterial Occlusive Diseases	Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.	Arterial Obstructive Diseases,Arterial Occlusion,Arterial Obstructive Disease,Arterial Occlusions,Arterial Occlusive Disease,Disease, Arterial Obstructive,Disease, Arterial Occlusive,Obstructive Disease, Arterial,Occlusion, Arterial,Occlusive Disease, Arterial
D016491	Peripheral Vascular Diseases	Pathological processes involving any one of the BLOOD VESSELS in the vasculature outside the HEART.	Peripheral Angiopathies,Vascular Diseases, Peripheral,Diseases, Peripheral Vascular,Angiopathies, Peripheral,Angiopathy, Peripheral,Disease, Peripheral Vascular,Peripheral Angiopathy,Peripheral Vascular Disease,Vascular Disease, Peripheral
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes