Antithrombotic therapy and major adverse limb events in patients with chronic lower extremity arterial disease:systematic review and meta-analysis from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy in Collaboration with the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases
| Autor: | Domenico D'Amario, Basil S. Lewis, Nils Kucher, Gianluigi Savarese, Dan Atar, Martin F Reiner, Claudio Borghi, Keld Kjeldsen, Anne Grete Semb, Juan Tamargo, Patrick Sulzgruber, Alexander Niessner, Stefan Agewall, Thomas Andersen Schmidt, Victor Aboyans, Alicia Uijl, Lars H. Lund, Marco De Carlo, Heinz Drexel, Cristiana Vitale, Juan Carlos Kaski, Sven Wassmann, Iris Baumgartner |
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| Přispěvatelé: | University of Zurich, Savarese, Gianluigi, Reiner, Martin F, Uijl, Alicia, D Amario, Domenico, Agewall, Stefan, Atar, Dan, Baumgartner, Iri, Borghi, Claudio, De Carlo, Marco, Drexel, Heinz, Kaski, Juan Carlo, Kjeldsen, Keld P, Kucher, Nil, Lund, Lars H, Niessner, Alexander, Semb, Anne Grete, Schmidt, Thomas A, Sulzgruber, Patrick, Tamargo, Juan, Vitale, Cristiana, Wassmann, Sven, Aboyans, Victor, Lewis, Basil S |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Time Factors medicine.medical_treatment Administration Oral 030204 cardiovascular system & hematology meta-analysi 0302 clinical medicine Risk Factors Antithrombotic 2736 Pharmacology (medical) Pharmacology (medical) 030212 general & internal medicine Myocardial infarction 610 Medicine & health Stroke Randomized Controlled Trials as Topic Dual Anti-Platelet Therapy Middle Aged Cardiovascular disease Limb Salvage Treatment Outcome Lower Extremity Cardiology Female Cardiology and Cardiovascular Medicine medicine.medical_specialty Hemorrhage Revascularization Risk Assessment 2705 Cardiology and Cardiovascular Medicine Amputation Surgical 03 medical and health sciences Anticoagulation Peripheral Arterial Disease Pharmacotherapy Fibrinolytic Agents Internal medicine medicine Journal Article Humans Aged Antithrombotic therapy Peripheral artery disease business.industry 10031 Clinic for Angiology Antiplatelet therapy Bleeding Anticoagulants medicine.disease Lower extremity artery disease body regions Meta-analysis Amputation Relative risk Chronic Disease anti-thrombotic therapy business Fibrinolytic agent Platelet Aggregation Inhibitors |
| Zdroj: | Savarese, G, Reiner, M F, Uijl, A, D'Amario, D, Agewall, S, Atar, D, Baumgartner, I, Borghi, C, De Carlo, M, Drexel, H, Kaski, J C, Kjeldsen, K P, Kucher, N, Lund, L H, Niessner, A, Semb, A G, Schmidt, T A, Sulzgruber, P, Tamargo, J, Vitale, C, Wassmann, S, Aboyans, V & Lewis, B S 2020, ' Antithrombotic therapy and major adverse limb events in patients with chronic lower extremity arterial disease : systematic review and meta-analysis from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy in Collaboration with the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases ', European Heart Journal-Cardiovascular Pharmacotherapy, vol. 6, no. 2, pp. 86-93 . https://doi.org/10.1093/ehjcvp/pvz036 Savarese, Gianluigi; Reiner, Martin F; Uijl, Alicia; D Amario, Domenico; Agewall, Stefan; Atar, Dan; Baumgartner, Iris; Borghi, Claudio; De Carlo, Marco; Drexel, Heinz; Kaski, Juan Carlos; Kjeldsen, Keld P; Kucher, Nils; Lund, Lars H; Niessner, Alexander; Semb, Anne Grete; Schmidt, Thomas A; Sulzgruber, Patrick; Tamargo, Juan; Vitale, Cristiana; ... (2020). Antithrombotic Therapy and Major Adverse Limb Events in Patients With Chronic Lower Extremity Arterial Disease: Systematic Review and Meta-analysis from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy in Collaboration with the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases. European heart journal-cardiovascular pharmacotherapy, 6(2), pp. 86-93. Oxford University Press 10.1093/ehjcvp/pvz036 Savarese, G, Reiner, M F, Uijl, A, D´Amario, D, Agewall, S, Atar, D, Baumgartner, I, Borghi, C, De Carlo, M, Drexel, H, Kaski, J C, Kjeldsen, K P, Kucher, N, Lund, L H, Niessner, A, Semb, A G, Schmidt, T A, Sulzgruber, P, Tamargo, J, Vitale, C, Wassmann, S, Aboyans, V & Lewis, B S 2020, ' Antithrombotic Therapy and Major Adverse Limb Events in Patients With Chronic Lower Extremity Arterial Disease : Systematic Review and Meta-analysis from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy in Collaboration with the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases ', European Heart Journal-Cardiovascular Pharmacotherapy, vol. 6, no. 2, pp. 86-93 . https://doi.org/10.1093/ehjcvp/pvz036 European heart journal-Cardiovascular pharmacotherapy, 6(2), 86 |
| ISSN: | 2055-6845 2055-6837 |
| Popis: | Aims The role and selection of antithrombotic therapy to improve limb outcomes in chronic lower extremity artery disease (LEAD) is still debated. We conducted a meta-analysis to examine the efficacy and safety of antithrombotic and more intense antithrombotic therapy on limb outcomes and limb salvage in patients with chronic LEAD. Methods and results Study inclusion criteria were: enrolment of patients with LEAD, randomized allocation to more vs. less intense antithrombotic therapy [more vs. less intense single-antiplatelet therapy (SAPT); dual-antiplatelet therapy vs. SAPT; dual antithrombotic therapy vs. SAPT or oral anticoagulant]; enrolment of ≥200 patients; reporting of at least one of following outcomes: limb amputation or revascularization. Seven randomized studies enrolling 30 447 patients were included. Over a median follow-up of 24 months, more vs. less intense antithrombotic therapy or placebo significantly reduced the risk of limb revascularization [relative risk (RR) 0.89, 95% confidence interval (CI) 0.83–0.94] and limb amputation (RR 0.63, 95% CI 0.46–0.86), as well as stroke (RR 0.82, 95% CI 0.70–0.97). There was no statistically significant effect on the risk of myocardial infarction (RR 0.98, 95% CI 0.87–1.11), all-cause (RR 0.93, 95% CI 0.86–1.01), and cardiovascular death (RR 0.97, 95% CI 0.86–1.08). Risk of major bleeding increased (RR 1.23, 95% CI 1.04–1.44). Conclusion In patients with LEAD, more intense antithrombotic therapy reduces the risk of limb amputation and revascularization as well as stroke with an increase in the risk of bleeding events. |
| Databáze: | OpenAIRE |
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