Abstract | OBJECTIVES: To investigate the influence of dual antiplatelet therapy vs. aspirin alone on local platelet activation and clinical endpoints in patients with PAD treated with endovascular therapy. METHODS: Patients received either 500 mg aspirin and 300 mg clopidogrel before intervention followed by a daily dose of 100 mg aspirin and 75 mg clopidogrel for 6 months, or the same doses of aspirin plus placebo instead of clopidogrel. Primary endpoints were local concentrations of platelet activation markers β-thromboglobulin and CD40L, and the rate of patient's resistant to clopidogrel. Secondary endpoints included the clinical development 6 months after the intervention. RESULTS: Eighty patients, 40 in each group, were enrolled. The median peri-interventional concentration of β-TG was 224.5 vs. 365.5 (P = 0.03) in the clopidogrel and placebo group. The concentration of CD40L was 127 and 206.5 (P = 0.05). Thirty per cent of patients who had received clopidogrel were resistant. Two clopidogrel and eight placebo patients required TLR (P = 0.04). The clopidogrel patients who needed revascularisation were both resistant to clopidogrel. Minor bleeding complications occurred in one clopidogrel and two placebo patients. CONCLUSION: Dual antiplatetet therapy reduces peri-interventional platelet activation and improves functional outcome without higher bleeding complications. An individual tailored dual antiplatelet therapy seems desirable for endovascularly treated patients with PAD.
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Authors | Gunnar Tepe, Rüdiger Bantleon, Klaus Brechtel, Jörg Schmehl, Thomas Zeller, Claus D Claussen, Frederik F Strobl |
Journal | European radiology
(Eur Radiol)
Vol. 22
Issue 9
Pg. 1998-2006
(Sep 2012)
ISSN: 1432-1084 [Electronic] Germany |
PMID | 22569995
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Platelet Aggregation Inhibitors
- Aspirin
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Topics |
- Aged
- Angioplasty
(adverse effects)
- Aspirin
(therapeutic use)
- Double-Blind Method
- Female
- Humans
- Male
- Peripheral Arterial Disease
(complications, surgery)
- Platelet Aggregation Inhibitors
(therapeutic use)
- Thrombosis
(drug therapy, etiology)
- Treatment Outcome
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