Prophylactic antiplatelet therapy in peripheral arterial disease.

Prophylactic therapy with antiplatelet drugs aims to improve both the general prognosis of patients and the local progression of peripheral arterial disease. A recent meta-analysis of 28 trials revealed that the proportional risk reduction in serious vascular events is similar to that in cardio- and cerebrovascular disease. A decreased incidence of vascular complications was also found in a meta-analysis of 4 trials with ticlopidine, and a recent Swedish study [Swedish Ticlopidine Multicentre Study (STIMS)] confirmed that long term ticlopidine reduces both mortality and cardio- and cerebrovascular morbidity. There is also evidence that aspirin (acetylsalicylic acid) and ticlopidine retard progression of atherosclerosis and the occurrence of its thrombotic complications, in patients with arterial disease of the legs. Meta-analysis has recently indicated that antiplatelet agents reduce the incidence of graft occlusion in arterial surgery. These drugs are also traditionally prescribed after percutaneous revascularisation procedures. The efficacy of antiplatelet therapy in patients with peripheral arterial disease emphasises the role of platelets in this condition.