Antiplatelet therapy after endovascular intervention: does combination therapy really work and what is the optimum duration of therapy?
The number of patients undergoing peripheral interventions has increased in recent years, highlighting the need for a safe and effective protective antithrombotic therapy. Platelet inhibition following coronary intervention is associated with a significantly reduced risk of graft occlusion, and has been acknowledged to be safe and effective in patients with peripheral arterial disease. Monotherapy with either aspirin or clopidogrel, reduces the rate of stroke, myocardial infarction, and cardiovascular death in patients suffering from peripheral arterial disease. Limited data from clinical trials investigating combination therapy of aspirin with ticlopidine or clopidogrel in patients undergoing endovascular interventions, have suggested the potential for a reduction in cardiovascular events. Nevertheless, the optimal duration of postintervention antiplatelet therapy remains to be defined.
Milani
Richard V
RV
Department of Cardiology, Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. rmilani@ochsner.org
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001241:Aspirin / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000077144:Clopidogrel; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D013927:Thrombosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin