Author + information
- Received December 26, 2017
- Revision received March 16, 2018
- Accepted March 21, 2018
- Published online May 21, 2018.
- Mohamad A. Hussain, MD, PhDa,b,c,
- Mohammed Al-Omran, MD, MScb,c,d,
- Mark A. Creager, MDe,
- Sonia S. Anand, MD, PhDf,
- Subodh Verma, MD, PhDb,g and
- Deepak L. Bhatt, MD, MPHa,h,∗ (, )@DLBHATTMD
- aBrigham and Women’s Hospital Heart & Vascular Center, Boston, Massachusetts
- bDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada
- cDivision of Vascular Surgery, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- dDepartment of Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia
- eDartmouth-Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- fHamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- gDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
- hHarvard Medical School, Boston, Massachusetts
- ↵∗Address for correspondence:
Dr. Deepak L. Bhatt, Brigham and Women’s Hospital Heart & Vascular Center, Harvard Medical School, 75 Francis Street, Boston, Massachusetts 02115.
Peripheral artery disease (PAD) affects over 200 million people globally and is a cause of significant morbidity, mortality, and disability due to limb loss. Although secondary prevention with antithrombotic therapy is a mainstay of treatment to prevent adverse cardiovascular events, PAD patients are often undertreated with antithrombotic agents. Furthermore, there is a paucity of high-quality data from randomized controlled trials of PAD patients, leading to wide variations in clinical practice and guideline recommendations. Recently, there have been important advances that have further increased the number of antiplatelet and anticoagulant choices potentially available for patients with PAD. In this context, this paper aims to summarize the current available evidence for the safety and efficacy of various antithrombotic agents in PAD, and discuss how to integrate this emerging evidence into actual clinical practice. An evidenced-based approach to PAD patients is essential to achieve optimal outcomes, weighing cardiovascular and limb benefits against bleeding risks.
Dr. Anand has received speaker honoraria from Bayer and Novartis. Dr. Verma has received speaker honoraria from Boehringer Ingelheim, Bayer, Pfizer, Sanofi, Eli Lilly, Amgen, AstraZeneca, Mylan, Merck, Janssen, Novo Nordisk, and Abbott; and research support from Amgen, AstraZeneca, Boehringer Ingelheim, and Eli Lilly. Dr. Bhatt has served on the advisory board for Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; has served on the board of directors of the Boston VA Research Institute and Society of Cardiovascular Patient Care; has served as the chair of American Heart Association Quality Oversight Committee; has served on the data monitoring committees of the Cleveland Clinic, Duke Clinical Research Institute, Harvard Clinical Research Institute, Mayo Clinic, and Population Health Research Institute; has received honoraria from the American College of Cardiology (senior associate editor, Clinical Trials and News, ACC.org), Belvoir Publications (Editor-in-Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), Harvard Clinical Research Institute (clinical trial steering committee), HMP Communications (Editor-in-Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (guest editor; associate editor), Population Health Research Institute (clinical trial steering committee), Slack Publications (chief medical editor, Cardiology Today Intervention), Society of Cardiovascular Patient Care (secretary/treasurer), and WebMD (CME steering committees); has served as the deputy editor for Clinical Cardiology; has served as the chair of the NCDR-ACTION Registry Steering Committee and VA CART Research and Publications Committee; has received research funding from Abbott, Amarin, Amgen, AstraZeneca, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Ironwood, Ischemix, Lilly, Medtronic, Pfizer, Roche, Sanofi, and The Medicines Company; has received royalties from Elsevier (editor, Cardiovascular Intervention: A Companion to Braunwald Heart Disease); has served as a site co-investigator for Biotronik, Boston Scientific, and St. Jude Medical (now Abbott); has served as a trustee of American College of Cardiology; and has performed unfunded research for FlowCo, PLx Pharma, and Takeda. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 26, 2017.
- Revision received March 16, 2018.
- Accepted March 21, 2018.
- 2018 American College of Cardiology Foundation
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