Antithrombotic Therapy in Patients with Peripheral Artery Disease: A Focused Review on Oral Anticoagulation

Autor: María Asunción Esteve-Pastor, Antonio Tello-Montoliu, Francisco Marín, Pablo Gil-Pérez, Esteban Orenes-Piñero, Anny Camelo-Castillo, Inmaculada Ramírez-Macías, Cecilia López-García, José Miguel Rivera-Caravaca
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
medicine.drug_class
QH301-705.5
medicine.medical_treatment
Review
030204 cardiovascular system & hematology
Revascularization
peripheral artery disease
Catalysis
antiplatelet therapy
Inorganic Chemistry
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
Fibrinolytic Agents
Antithrombotic
Humans
Medicine
Thrombolytic Therapy
030212 general & internal medicine
Physical and Theoretical Chemistry
Biology (General)
Adverse effect
Intensive care medicine
Blood Coagulation
Molecular Biology
rivaroxaban
QD1-999
Spectroscopy
Rivaroxaban
Aspirin
anticoagulation therapy
business.industry
Organic Chemistry
Anticoagulant
Anticoagulants
Thrombosis
General Medicine
medicine.disease
Computer Science Applications
Venous thrombosis
Chemistry
Drug Therapy
Combination
business
Platelet Aggregation Inhibitors
Factor Xa Inhibitors
medicine.drug
Zdroj: International Journal of Molecular Sciences, Vol 22, Iss 7113, p 7113 (2021)
International Journal of Molecular Sciences
ISSN: 1661-6596
1422-0067
Popis: Peripheral artery disease (PAD) is a major cause of morbidity and mortality but it is usually underdiagnosed and undertreated. Patients with PAD present dysregulated procoagulant, anticoagulant, and fibrinolytic pathways leading to arterial and venous thrombosis. The risk of several ischemic-related complications could be mitigated with appropriate antithrombotic therapy, which plays a central role in all types of PAD. For years, antiplatelets have been indicated in patients with symptomatic PAD or those who have undergone revascularization. Unfortunately, a non-negligible proportion of patients with PAD will suffer from adverse events during the follow-up, even despite proper medical therapies for the prevention of PAD complications. Thus, there is room for improving clinical outcomes in these patients. Given the implication of both, primary and secondary hemostasis in arterial thrombosis and the pathophysiology of PAD, the combination of antiplatelets and anticoagulants has emerged as a potential antithrombotic alternative to antiplatelets alone. In this narrative review article, we have highlighted the most recent evidence about antithrombotic therapy in PAD patients, with a special focus on oral anticoagulation. Certainly, COMPASS and VOYAGER PAD trials have shown promising results. Thus, rivaroxaban in combination with aspirin seem to reduce cardiovascular outcomes with a similar bleeding risk compared to aspirin alone. Nevertheless, results from real-world studies are needed to confirm these observations, and other trials will provide novel evidence about the safety and efficacy of emerging anticoagulant agents.
Databáze: OpenAIRE
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