Key result
Dual anti-platelet therapy and combined anti-coagulation with anti-platelets are key in preventing major cardiovascular events, stroke, death, and disease progression in peripheral artery disease.
Why the study?
Peripheral artery disease is a major clinical comorbidity affecting quality of life, focusing the review on anti-platelet and anti-coagulation medical management prior to surgical or endovascular management.
Does anti-platelet and anti-coagulation therapy prevent major cardiovascular events and disease progression in patients with peripheral artery disease prior to surgical intervention?
Does anti-platelet and anti-coagulation therapy prevent major cardiovascular events and disease progression in patients with peripheral artery disease prior to surgical intervention?
This review highlights the importance of dual anti-platelet therapy and combined anti-coagulation in managing peripheral artery disease prior to surgical intervention to prevent cardiovascular events and disease progression.
Answers are grounded in this paper and cite their sources.
May support antithrombotic regimens in pre-surgical PAD; leaves open confirmation by randomized trials.
OBJECTIVE: Peripheral artery disease is a major clinical co-morbidity that can significantly affect quality of life, especially in the presence of diabetes mellitus and older age. The focus of this literature review is on medical management, through anti-platelet and anti-coagulation, of peripheral artery disease prior to undergoing surgical or endovascular management. METHOD: Extensive electronic literature search performed in four major databases (PubMed, SCOPUD, Embase and Ovid) to identify the published randomized and non-randomized studies that compared and discussed the management of peripheral artery disease with different anti-thrombotic agents. RESULTS: A total of 17 studies were identified to meet the inclusion criteria of this review. Among them, 4 were systematic review and meta-analyses, 1 was observational study and 12 were randomized controlled trials. The reported outcomes in each study are summarized and reported separately within this review. CONCLUSION: Peripheral artery disease is a complex and multifactorial clinical condition. The use of dual anti-platelets, such as aspirin and clopidogrel, are the key in preventing major cardiovascular events as well as stroke and death. Utilization of anti-coagulation such as direct oral anti-coagulants' as additional parameters for the prevention of disease progression, is paramount. Eventually, the choice of either dual-antiplatelet therapy or combined anti-coagulation with anti-platelets should be carefully considered, particularly following the most recent published debatable studies.
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Harky et al. (2018) conducted a review in Peripheral artery disease (n=17). Anti-platelet and anti-coagulant therapy was evaluated. Dual anti-platelet therapy and combined anti-coagulation with anti-platelets are key in preventing major cardiovascular events, stroke, death, and disease progression in peripheral artery disease.
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