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Thromb Haemost 2010; 103(04): 766-773
DOI: 10.1160/TH09-09-0635
Platelets and Blood Cells
Schattauer GmbH

Comparison of efficacy of antiplatelet treatments for patients with claudication

A meta-analysis
Stefania Basili
1   Internal Medicine Division – Atherothrombosis Centre and BioMedical Statistics and Clinical Epidemiology Centre, Department of Experimental Medicine, “La Sapienza” University of Rome, Italy
,
Valeria Raparelli
1   Internal Medicine Division – Atherothrombosis Centre and BioMedical Statistics and Clinical Epidemiology Centre, Department of Experimental Medicine, “La Sapienza” University of Rome, Italy
,
Annarita Vestri
1   Internal Medicine Division – Atherothrombosis Centre and BioMedical Statistics and Clinical Epidemiology Centre, Department of Experimental Medicine, “La Sapienza” University of Rome, Italy
,
Gian Luca Di Tanna
1   Internal Medicine Division – Atherothrombosis Centre and BioMedical Statistics and Clinical Epidemiology Centre, Department of Experimental Medicine, “La Sapienza” University of Rome, Italy
,
Francesco Violi
1   Internal Medicine Division – Atherothrombosis Centre and BioMedical Statistics and Clinical Epidemiology Centre, Department of Experimental Medicine, “La Sapienza” University of Rome, Italy
› Author Affiliations
Further Information

Publication History

Received: 10 September 2009

Accepted after major revision: 13 February 2009

Publication Date:
22 November 2017 (online)

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Summary

It was the aim of the present study to investigate if antiplatelet treatment reduced cardiovascular events in patients with claudication and/ or an ankle/brachial index (ABI) ≤0.99 and to analyse if specific antiplatelet treatment had a different impact on clinical outcome. We performed a meta-analysis of 29 clinical randomized trials on antiplatelet therapy for prevention of vascular death, myocardial infarction, and stroke in 10,735 peripheral artery disease patients. The primary end-point utilizing in the meta-analysis construction was Cardiovascular Adverse Event. We found 1,900 (17.70%) patients in trials with aspirin, 5,326 (49.61%) in those with thienopyridines, 2,324 (21.65%) in those with picotamide and 1,185 (11.04 %) in those with others antiplatelet drugs. A statistically significant effect of antiplatelet treatment [odds ratio (OR) 0.839; 95% confidence interval (CI) 0.729–0.965; p=0.014] was observed. There was a statistically significant reduction of clinical outcome [OR 0.779; 95% CI 0.639–0.950; p=0.014] in the thienopyridine-treated group vs. control. Patients treated with picotamide [OR 0.785; 95% CI 0.495–1.243; p=0.302] or aspirin [OR 0.847; 95%CI 0.653–1.097; p=0.084] showed reduced cardiovascular outcomes, that, however, did not reach significance. The study confirms that anti-platelet treatment reduces vascular outcome in claudicants. Significant reduction was observed with thienopyridines while data regarding aspirin and picotamide were inconclusive.

Keywords

Antiplatelet agents - atherosclerosis - atherothrombosis - clinical trials - antiplatelet drugs - vasculopathies
 

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