Antiplatelet therapy after endovascular intervention: does combination therapy really work and what is the optimum duration of therapy?

Catheter Cardiovasc Interv. 2009 Jul 1:74 Suppl 1:S7-S11. doi: 10.1002/ccd.21996.

Abstract

The number of patients undergoing peripheral interventions has increased in recent years, highlighting the need for a safe and effective protective antithrombotic therapy. Platelet inhibition following coronary intervention is associated with a significantly reduced risk of graft occlusion, and has been acknowledged to be safe and effective in patients with peripheral arterial disease. Monotherapy with either aspirin or clopidogrel, reduces the rate of stroke, myocardial infarction, and cardiovascular death in patients suffering from peripheral arterial disease. Limited data from clinical trials investigating combination therapy of aspirin with ticlopidine or clopidogrel in patients undergoing endovascular interventions, have suggested the potential for a reduction in cardiovascular events. Nevertheless, the optimal duration of postintervention antiplatelet therapy remains to be defined.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary / adverse effects
  • Aspirin / therapeutic use
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / physiopathology
  • Clopidogrel
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Evidence-Based Medicine
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / prevention & control
  • Humans
  • Myocardial Infarction / etiology
  • Myocardial Infarction / prevention & control
  • Peripheral Vascular Diseases / complications
  • Peripheral Vascular Diseases / drug therapy*
  • Peripheral Vascular Diseases / physiopathology
  • Peripheral Vascular Diseases / surgery
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Thrombosis / etiology
  • Thrombosis / physiopathology
  • Thrombosis / prevention & control*
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Time Factors
  • Treatment Outcome
  • Vascular Patency

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin