title: The Burden of Major Adverse Cardiac Events and Antiplatelet Prevention in Patients with Coronary or Peripheral Arterial Disease.
abstract: BACKGROUND
  Patients with a history of a cardiovascular (CV) disease are at high risk of suffering secondary major adverse cardiac events (MACE), namely death, nonfatal myocardial infarction (MI), stroke, symptomatic pulmonary embolism, CV and all-cause hospitalization, and bleeding.
  
  
  METHODS
  A comprehensive review of the literature was conducted to review the epidemiology and burden of MACE in patients with coronary or peripheral arterial disease (CAD or PAD) in Europe and other ex-US regions. Relevant articles published between 2003 and 2013 were retrieved from PubMed and other sites.
  
  
  RESULTS
  MACE incidence and prevalence in patients with CAD or PAD were increased by at least 1.4-fold compared with matched controls with no CV disease. In patients with CAD, MACE mostly occurred within 30 days of primary percutaneous coronary intervention; incidence decreased with time. Increased oxidative stress in coronary and peripheral arteries, diabetes, and chronic kidney disease were identified as the main risk factors for MACE in patients with CAD and PAD. Registry data showed that, although preventive antiplatelet therapy was prescribed at high rates, a large proportion (9-56%) of patients did not receive treatment. Furthermore, adherence to treatment declined over time, potentially leading to disease worsening.
  
  
  CONCLUSIONS
  Despite gaps in the literature, this assessment showed that MACE's risk is substantial among patients with CAD or PAD and that the use of preventive therapies is suboptimal. Development of additional preventive therapies for these patients is warranted.
authors.affiliation: LASER Analytica, Montreal, QC, Canada.
authors.forename: Hanane
authors.initials: H
authors.lastname: Khoury
authors.affiliation: LASER Analytica, Montreal, QC, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Lavoie
authors.affiliation: LASER Analytica, Montreal, QC, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Welner
authors.affiliation: Bayer Pharma AG, Wuppertal, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Folkerts
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D003324:Coronary Artery Disease / Q000453:epidemiology*; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Adverse cardiac events; Anticoagulation; Coronary artery disease; Peripheral arterial disease; Secondary prevention