Key result
Antithrombotic therapies after PAD revascularization left patients at residual risk, with amputation occurring in up to 7.3% and major bleeding in up to 8.4% of patients across 16 RCTs.
Why the study?
To identify and summarize the clinical efficacy and safety of available antithrombotic therapies after peripheral endovascular or surgical revascularization in patients with PAD.
Does antithrombotic therapy reduce thrombotic events in patients with peripheral artery disease following revascularization?
Systematic Review
Does antithrombotic therapy reduce thrombotic events in patients with peripheral artery disease following revascularization?
Despite available antithrombotic treatments, patients with PAD undergoing revascularization remain at significant risk for both thrombotic and bleeding events, highlighting an unmet need for optimized therapies.
High residual thrombotic and bleeding risks persist despite antithrombotic therapy after PAD revascularization; extends evidence of unmet need for optimized regimens.
A systematic literature review was conducted to identify and summarize the clinical efficacy and safety of available antithrombotic therapies after peripheral endovascular or surgical revascularization in patients with peripheral artery disease (PAD). Five databases were searched using free-text and Emtree/Mesh terms for PAD, randomized controlled trials (RCTs), and antithrombotic therapies of interest (ie, single antiplatelet therapy, dual antiplatelet therapy, and vitamin K antagonists). Randomized controlled trials were eligible for inclusion if they assessed the risk of thrombotic events (ie, myocardial infarction, ischemic stroke, cardiovascular death, limb ischemia, or limb amputation) or safety profile (ie, minor, moderate, major, or fatal bleeding events) after revascularization. In total, 16 RCTs were identified. Only a few studies reported on treatment effects of the investigated therapies. Myocardial infarction, ischemic stroke, cardiovascular death, and amputation were reported in up to 2.3%, 2.3%, 5.6%, and 7.3% of patients, respectively. Bleeding events were observed in up to 8.4% (major) and 1.5% (fatal) of patients. Despite available treatments, patients with PAD undergoing revascularization remain at risk of thrombotic events. There is a need for new treatments that will help to optimize care for patients with symptomatic PAD undergoing revascularization.
No takes yet. Share an insight, caveat, or question.
Schindewolf et al. (2020) conducted a systematic review in Peripheral artery disease (PAD). Antithrombotic therapies (single antiplatelet, dual antiplatelet, vitamin K antagonists) was evaluated on Thrombotic events (myocardial infarction, ischemic stroke, cardiovascular death, limb ischemia, or limb amputation) and safety profile (bleeding events). Antithrombotic therapies after PAD revascularization left patients at residual risk, with amputation occurring in up to 7.3% and major bleeding in up to 8.4% of patients across 16 RCTs.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: