Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease
After infrainguinal endovascular treatment for peripheral arterial disease (PAD), it is uncertain whether single antiplatelet therapy (SAPT) or dual antiplatelet therapy (DAPT) should be preferred. This study investigated major adverse limb events (MALE) and major adverse cardiovascular events (MACE...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-10-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/11/3515 |
| _version_ | 1797549300464484352 |
|---|---|
| author | Jetty Ipema Rutger H. A. Welling Olaf J. Bakker Reinoud P. H. Bokkers Jean-Paul P. M. de Vries Çagdas Ünlü |
| author_facet | Jetty Ipema Rutger H. A. Welling Olaf J. Bakker Reinoud P. H. Bokkers Jean-Paul P. M. de Vries Çagdas Ünlü |
| author_sort | Jetty Ipema |
| collection | DOAJ |
| description | After infrainguinal endovascular treatment for peripheral arterial disease (PAD), it is uncertain whether single antiplatelet therapy (SAPT) or dual antiplatelet therapy (DAPT) should be preferred. This study investigated major adverse limb events (MALE) and major adverse cardiovascular events (MACE) between patients receiving SAPT and DAPT. Patient data from three centers in the Netherlands were retrospectively collected and analyzed. All patients treated for PAD by endovascular revascularization of the superficial femoral, popliteal, or below-the-knee (BTK) arteries and who were prescribed acetylsalicylic acid or clopidogrel, were included. End points were 1-, 3-, and 12-month MALE and MACE, and bleeding complications. In total, 237 patients (258 limbs treated) were included, with 149 patients receiving SAPT (63%) and 88 DAPT (37%). No significant differences were found after univariate and multivariate analyses between SAPT and DAPT on 1-, 3-, and 12-month MALE and MACE, or bleeding outcomes. Subgroup analyses of patients with BTK treatment showed a significantly lower 12-month MALE rate when treated with DAPT (hazard ratio 0.33; 95% confidence interval 0.12–0.95; <i>p</i> = 0.04). In conclusion, although patient numbers were small, no differences were found between SAPT and DAPT regarding MALE, MACE, or bleeding complications. DAPT should, however, be considered over SAPT for the subgroup of patients with below-the-knee endovascular treatment. |
| first_indexed | 2024-03-10T15:12:44Z |
| format | Article |
| id | doaj.art-2de4161052cc437c9fae301e4bcd61b8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:12:44Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2de4161052cc437c9fae301e4bcd61b82023-11-20T19:09:13ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-01911351510.3390/jcm9113515Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial DiseaseJetty Ipema0Rutger H. A. Welling1Olaf J. Bakker2Reinoud P. H. Bokkers3Jean-Paul P. M. de Vries4Çagdas Ünlü5Department of Surgery, Northwest Clinics, Wilhelminalaan 12, 1815 JD Alkmaar, The NetherlandsDepartment of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The NetherlandsDepartment of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The NetherlandsDepartment of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Surgery, Northwest Clinics, Wilhelminalaan 12, 1815 JD Alkmaar, The NetherlandsAfter infrainguinal endovascular treatment for peripheral arterial disease (PAD), it is uncertain whether single antiplatelet therapy (SAPT) or dual antiplatelet therapy (DAPT) should be preferred. This study investigated major adverse limb events (MALE) and major adverse cardiovascular events (MACE) between patients receiving SAPT and DAPT. Patient data from three centers in the Netherlands were retrospectively collected and analyzed. All patients treated for PAD by endovascular revascularization of the superficial femoral, popliteal, or below-the-knee (BTK) arteries and who were prescribed acetylsalicylic acid or clopidogrel, were included. End points were 1-, 3-, and 12-month MALE and MACE, and bleeding complications. In total, 237 patients (258 limbs treated) were included, with 149 patients receiving SAPT (63%) and 88 DAPT (37%). No significant differences were found after univariate and multivariate analyses between SAPT and DAPT on 1-, 3-, and 12-month MALE and MACE, or bleeding outcomes. Subgroup analyses of patients with BTK treatment showed a significantly lower 12-month MALE rate when treated with DAPT (hazard ratio 0.33; 95% confidence interval 0.12–0.95; <i>p</i> = 0.04). In conclusion, although patient numbers were small, no differences were found between SAPT and DAPT regarding MALE, MACE, or bleeding complications. DAPT should, however, be considered over SAPT for the subgroup of patients with below-the-knee endovascular treatment.https://www.mdpi.com/2077-0383/9/11/3515peripheral arterial diseaseantiplatelet therapyendovascular interventionacetylsalicylic acidclopidogrel |
| spellingShingle | Jetty Ipema Rutger H. A. Welling Olaf J. Bakker Reinoud P. H. Bokkers Jean-Paul P. M. de Vries Çagdas Ünlü Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease Journal of Clinical Medicine peripheral arterial disease antiplatelet therapy endovascular intervention acetylsalicylic acid clopidogrel |
| title | Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease |
| title_full | Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease |
| title_fullStr | Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease |
| title_full_unstemmed | Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease |
| title_short | Short-Term Clinical Outcomes of Single Versus Dual Antiplatelet Therapy after Infrainguinal Endovascular Treatment for Peripheral Arterial Disease |
| title_sort | short term clinical outcomes of single versus dual antiplatelet therapy after infrainguinal endovascular treatment for peripheral arterial disease |
| topic | peripheral arterial disease antiplatelet therapy endovascular intervention acetylsalicylic acid clopidogrel |
| url | https://www.mdpi.com/2077-0383/9/11/3515 |
| work_keys_str_mv | AT jettyipema shorttermclinicaloutcomesofsingleversusdualantiplatelettherapyafterinfrainguinalendovasculartreatmentforperipheralarterialdisease AT rutgerhawelling shorttermclinicaloutcomesofsingleversusdualantiplatelettherapyafterinfrainguinalendovasculartreatmentforperipheralarterialdisease AT olafjbakker shorttermclinicaloutcomesofsingleversusdualantiplatelettherapyafterinfrainguinalendovasculartreatmentforperipheralarterialdisease AT reinoudphbokkers shorttermclinicaloutcomesofsingleversusdualantiplatelettherapyafterinfrainguinalendovasculartreatmentforperipheralarterialdisease AT jeanpaulpmdevries shorttermclinicaloutcomesofsingleversusdualantiplatelettherapyafterinfrainguinalendovasculartreatmentforperipheralarterialdisease AT cagdasunlu shorttermclinicaloutcomesofsingleversusdualantiplatelettherapyafterinfrainguinalendovasculartreatmentforperipheralarterialdisease |