title: Effect of aspirin versus clopidogrel on walking exercise performance in intermittent claudication-a double-blind randomized multicenter trial.
abstract: BACKGROUND
  This study sought to determine possible effects of different antiplatelet therapies on walking exercise performance in intermittent claudication. Aspirin, in contrast to clopidogrel, interferes with processes that increase collateral conductance in an ischemic animal model.
  
  
  RESULTS
  Patients with stable intermittent claudication were recruited from 21 centers in Switzerland and Germany and randomized to either aspirin or clopidogrel treatment. They participated in a 3-month rehabilitation program (electronically monitored, home-based, 1-hour daily walking sessions at a speed of approximately 120 steps/min). Walking distance was assessed by treadmill tests (3.2 km/h; 12% grade) at baseline and after 12 weeks. A total of 229 of 259 patients with a mean age of 66.2±7.7 years completed the study according to the protocol. A total of 24.5% were females, 20.1% diabetics, and 85.6% were active/ex-smokers. The baseline characteristics were a median (interquartile range) ankle/brachial index of 0.69 (0.57±0.8), an initial claudication distance (ICD) of 98 m (70 to 151 m), and an absolute claudication distance (ACD) of 162 m (113 to 302 m). Training resulted in a median increase of initial claudication distance by 33.5 m (33.3%) in the clopidogrel group and 29 m (33.9%) in the aspirin group. The values for absolute claudication distance were 60.5 m (34.9%) and 75 m (35.3%), respectively (p(ICD)=0.42 and p(ACD)=0.66).
  
  
  CONCLUSIONS
  Treatment with aspirin did not show a difference in initial claudication distance or absolute claudication distance improvements compared with clopidogrel after a 3-month walking rehabilitation program. (J Am Heart Assoc. 2012;1:51-56.)
  
  
  BACKGROUND
  URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00189618, URL: https://EudraCT.ema.europa.eu, Unique identifier: 2004-005041-35.
authors.affiliation: Department of Angiology, University Hospital, University of Basel,  Switzerland (E.S., S.I., D.S., K.-H.L., K.A.J.).
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Singer
authors.forename: Stephan
authors.initials: S
authors.lastname: Imfeld
authors.forename: Daniel
authors.initials: D
authors.lastname: Staub
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Ivo
authors.initials: I
authors.lastname: Buschmann
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Labs
authors.forename: Kurt A
authors.initials: KA
authors.lastname: Jaeger
keywords: antiplatelet therapy; claudication; exercise training; peripheral artery disease