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SVMB: Antiplatelet Therapy Appears to Reduce Need for Leg Bypass Surgery By Ed Susman CHICAGO, IL -- June 10, 2003 -- A meta-analysis of studies involving antiplatelet therapy for treatment of peripheral artery disease indicates that the treatment can reduce the need for leg artery bypass surgery. "Although the studies cannot prove it, we believe that the reduction in bypass surgery would reflect the ability of the drugs to prevent limb amputation," said Tracie Collins, MD, assistant professor of medicine at Baylor College of Medicine, in Houston, Texas. In her study, presented as a poster here on June 7th at the 14th Annual Meeting of the Society for Vascular Medicine and Biology, Dr. Collins analysed six studies on use of antiplatelet therapy in peripheral artery disease specifically seeking information on limb outcomes. She found that in patients on antiplatelet therapy -- specifically aspirin, ticlopidine, clopidogrel, or cilostazol -- the risk of requiring later limb bypass surgery was reduced by 45%, which was significant to the P<0.05 level. "Antiplatelet therapy appears to reduce the need for bypass surgery," Dr. Collins said. The studies also indicate that ticlopidine and cilostazol "improve pain-free walking distance as early as 4 weeks from the start of therapy," she noted. Dr. Collins and her colleagues identified 94 articles in the literature that applied to antiplatelet therapy. They then identified six studies that looked for evidence of limb outcomes -- two looked at aspirin; two ticlopidine, and two cilostazol. The studies analysed included more than 23,000 patients; most were involved in one study looking at aspirin. The scarcity of the data meant that determining if anti-platelet therapy actually saved a patient's leg would not be possible. "Additional randomised trials to assess the benefits of antiplatelet therapy and atherosclerotic risk factor control focusing on patients with peripheral artery disease are needed," Dr. Collins said. "The study demonstrates the systemic effects of antiplatelet therapy on long-term symptoms of patients with peripheral artery disease," said Alan T. Hirsch, MD, an assistant professor of medicine and director of the Vascular Medicine Program of the University of Minnesota Vascular Diseases Center. Dr. Hirsch said the work by Dr. Collins also shows the need for more clinical trials to evaluate effects on limb salvage. [Study title: Meta-Analysis of the Benefits of Antiplatelet Therapy for Systemic and Limb Outcomes in Peripheral Arterial Disease. Abstract P4] E-mail this page to a friend or colleague! To print, use this version