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Audio:DAPT: What Have We Learned Since CAPRIE, CREDO?

Describe the CAPRIE and CREDO studies and the increasing importance of identifying patients with PAD and managing their their atherosclerotic and thrombotic risk.

Audio:Incidence, Timing and Type of First and Recurrent Ischemic Event in Patients With and Without Peripheral Artery Disease following an Acute Coronary Syndrome

Secondary prevention therapies and positive lifestyle interventions benefit high-risk patients with PAD and concomitant CAD.

Audio:PAD: Public Awareness and Understanding of Disease Connections is Low—Patient and Provider Responsibilities

Advocacy and education initiatives are key to improving awareness of PAD among patients and providers.

Audio:Lessons From the REACH Registry: Understanding Persistent Thrombotic Risk in Patients with Atherosclerotic Disease

Describe the link between atherosclerosis and PAD, and explain the long-term risk of events that exists for patients with PAD.

Audio:What's New in Assessment of Risk and the Management of CAD in the Elderly?

This discussion examines heart disease treatment guidelines as they apply to the growing elderly U.S. population.

Audio:Patients with Polyvascular Disease

Desribing the prevalence of polyvascular disease, and implications for patients in terms of risk/outcomes.

Video:Weitz Anticoagulation Video

This animated video describes the disease process of abnormal blood clot formation resulting from atherosclerotic plaque ruptures and the importance of managing risk factors associated with thrombosis.

Audio:CAD and PAD: A Public Health Issue

Reviewing the prevalence and incidence of CAD and PAD, and the challenges that face physicians who manage patients at risk for these diseases.

PDF:The underlying thrombotic risk in CAD and PAD, Branch KR, et al.

While we in the medical community can appropriately pat ourselves on the back for winning numerous battles, the war on atherosclerosis is not over. We have not cured atherosclerosis.

Link:Mortality rates and mortality predictors in patients with symptomatic peripheral artery disease stratified according to age and diabetes, Mueller T, et al.

Atherosclerotic peripheral arterial disease (PAD) is one of the most prevalent, morbid, and mortal diseases. The aim of this study was to evaluate mortality rates of patients with atherosclerotic PAD stratified according to age and diabetes and to determine predictors of death.

Audio:Smoking: What Can You Tell or Show Patients That Will Change Behavior?

Describing the link between smoking and PAD outcomes, and how physicians hold smoking cessation discussions with patients.

PDF:Peripheral artery disease: epidemiology and global perspectives, Fowkes FGR, et al.

The burden of peripheral artery disease is shifting rapidly from high-income to low-income and middle-income countries. This article examines the epidemiology of PAD and, where feasible, takes a global perspective.

Link:Coronary & Peripheral Artery Disease

This resource discusses the background and progression of Peripheral Artery Disease (PAD) and Coronary Artery Disease (CAD) and their association with arterial thrombosis.

Link:Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis, Fowkes FG, et al.

Lower extremity peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity, following coronary artery disease and stroke.This study provides the first comparison of the prevalence of peripheral artery disease between high - income countries (HIC) and low - income or middle - income countries (LMIC), establishes the primary risk factors for peripheral artery disease in these settings, and estimates the number of people living with peripheral artery disease regionally and globally.

Link:A Call to Action: Women and Peripheral Artery Disease; A Scientific Statement From the American Heart Association, Hirsch AT, et al.

Lower extremity atherosclerotic peripheral artery disease has a very high prevalence in most nations and in the United States. Lower extremity PAD is now known to be associated with equal morbidity and mortality and comparable (or higher) health economic costs as coronary heart disease (CHD) and ischemic stroke. Yet where surveyed, the public and clinicians (as well as health payers and government agencies) do not yet fully recognize the risks associated with PAD.

Link:Peripheral arterial disease in African Americans: clinical characteristics, leg symptoms, and lower extremity functioning, Rucker-Whitaker C, et al.

This article describes peripheral arterial disease (PAD) in African Americans, and compares findings in African Americans and whites with PAD.

Video:Coronary Artery Disease/Peripheral Artery Disease (CAD/PAD) Video

This brief video gives an overview of both Coronary Artery Disease (CAD) and Peripheral Artery Disease (PAD), the causes of these diseases, and their prevalence.

Video:Disease Awareness Video - CAD/PAD

Cardiovascular Disease is the leading cause of death globally. This video explains the causes of Coronary Artery Disease (CAD) and Peripheral Artery Disease (PAD), and discusses prevalence data from around the globe.

Audio:Major Adverse Limb Events

Describing MALE (ALI, CLI, amuptation,etc.) and their outcomes, and how patients at risk are managed.

Link:Gaps in Public Knowledge of Peripheral Arterial Disease; The First National PAD Public Awareness Survey, Hirsch AT, et al.

This article highlights a cross-sectional, population-based telephone survey of a nationally representative sample of 2501 adults greater than or equal to 50 years of age, with oversampling of blacks and Hispanics.

Link:Implications of Coronary Artery Disease in Heart Failure With Preserved Ejection Fraction, Hwang SJ, et al.

This study investigated the characteristics, evaluation, prognostic impact, and treatment of coronary artery disease (CAD) in patients with heart failure and preserved ejection fraction (HFpEF).

Link:The Prevalence of Polyvascular Disease in Patients Referred for Peripheral Arterial Disease, Vidakovic R, et al.

To objectively assess the presence of polyvascular disease in patients with peripheral arterial disease and its relation to inflammation and clinical risk factors.

Link:Peripheral Circulation of Veterans and Non-Veterans with Peripheral Artery Disease and Claudication, Gardner W.

The authors compared the peripheral vascular function of veterans and non-veterans with peripheral artery disease (PAD) and claudication.

Link:Thrombus Formation on Atherosclerotic Plaques: Pathogenesis and Clinical Consequences, Rauch U, et al.

This article describes the characteristics of thrombus formation on atherosclerotic plaques, the clinical expression of atherothrombosis in vascular disease, and some of the most recent therapeutic approaches in cardiovascular disease.

Link:Nonobstructive Coronary Artery Disease and Risk of Myocardial Infarction, Maddox TM, et al.

This article compares myocardial infarction (MI) and mortality rates between patients with nonobstructive CAD, obstructive CAD, and no apparent CAD in a national cohort.

Link:Sex differences in the prevalence and clinical outcomes of subclinical peripheral artery disease in the Health, Aging, and Body Composition (Health ABC) study, Hiramoto JS, et al.

The objective of the study was to determine if there are sex-based differences in the prevalence and clinical outcomes of subclinical peripheral artery disease (PAD).

Link:Insights into the role of thrombin in the pathogenesis of recurrent ischaemia after acute coronary syndrome, Weitz JI.

Acute coronary syndrome (ACS) is a medical emergency. Patients who survive the initial event remain at risk of recurrent cardiovascular events.

Audio:Coagulation and Atherothrombotic Events

The role of coagulation and platelet activation, and their relationship to cardiovascular events.

Link:Bleeding in acute coronary syndromes and percutaneous coronary interventions: position paper by the Working Group on Thrombosis of the European Society of Cardiology, Steg PG, et al.

Bleeding has recently emerged as an important outcome in the management of acute coronary syndromes (ACS), which is relatively frequent compared with ischaemic outcomes and has important implications in terms of prognosis, outcomes, and costs.

Link:Antiplatelet agents for intermittent claudication, Wong PF, et al.

Peripheral arterial disease (PAD) is common and is a marker of systemic atherosclerosis.

Link:Platelet activation and atherothrombosis, Davi G, et al.

Platelets are essential for primary hemostasis and repair of the endothelium, but they also play a key role in the development of acute coronary syndromes and contribute to cerebrovascular events.

Link:Thrombosis formation on atherosclerotic lesions and plaque rupture, Badimon L, et al.

This review describes the progression of the atherosclerotic lesion along with the main morphological characteristics that predispose to plaque rupture, discusses the multifaceted mechanisms that drive platelet activation and subsequent thrombus formation, and considers the current scientific challenges and future research directions.

Link:Coronary heart disease and atrial fibrillation: the Framingham Study, Kannel WB, et al.

In a recent report, epidemiologic features of chronic atrial fibrilation (AF) were described based on comprehensive biennial cardiovascular examinations of participants in the Framingham Heart Study.

Link:Gender-specific risk factors for peripheral artery disease in a voluntary screening population, Hiramoto JS, et al.

Women have high rates of peripheral artery disease (PAD) despite fewer cardiovascular disease (CVD) risk factors, compared to men.

Link:Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis, Fowkes FG, et al.

Lower extremity peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity, following coronary artery disease and stroke.

Link:Preoperative Ankle-Brachial Index Stratification for Patients With Peripheral Arterial Disease, Sun Y, et al.

The ankle-brachial index (ABI) is a well-accepted tool to assess severity of peripheral arterial disease (PAD). Categorization of ABI values to match clinical PAD severity (claudication, rest pain, and tissue loss) is based on limited data of a few hundred patients from 1970 and 1996. The American Heart Association guidelines recommended to change reporting of ABIs for cardiovascular risk stratification to normal, abnormal, borderline, and noncompressible. As such, reporting categories for ABI in PAD need re-evaluation.

Audio:Diabetes and the Real Risk of Developing CAD and/or PAD

Describing and explaining the increased risk relationship between diabetes and CAD/PAD, including how diabetes impacts the vascular system, endothelial function and platelets.

Audio:Smoking and Inflammation

Describing the role of chronic, systemic inflammation and its on patients with CAD and/or PAD, as well as the interaction between inflammation and smoking, inflammation and lipids.

Guidelines

Audio:Despite Guidelines-based Medical Care, Patients with PAD Have Events: What's Missing?

Recent developments in guideline-recommended therapy and medical care for patients with PAD.

PDF:2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease, Levine GN, et al.

This article reviews recommendations on duration of dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor) in patients with coronary artery disease.

PDF:2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS), Aboyans V, et al.

Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.

Audio:Ankle Brachial Index for PAD

Describing the most basic means of assessing existence of PAD.

PDF:Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II), Norgren L, et al.

The Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease (TASC) was published in January 2000 and had a major impact on vascular care amongst specialists.

PDF:2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, Gerhard-Herman MD, et al.

These guidelines, based on systematic methods to evaluate and classify evidence, provide a cornerstone of quality cardiovascular care.

Link:2013 ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology, Montalescot G, et al.

These guidelines should be applied to patients with stable known or suspected coronary artery disease (SCAD).

PDF:Management of patients with NSTE-ACS: a comparison of the recent AHA/ACC and ESC Guidelines, Rodriguez F, et al.

Non–ST-segment elevation acute coronary syndromes (NSTE-ACS) are the leading cause of morbidity and mortality from cardiovascular disease worldwide.

Outcomes

Audio:Impact of Antiplatelet Therapy on Mortality in Patients With Cardiovascular and Cerebrovascular Disease

Describe the risk and outcomes among patients with CAD and CVD, and the impact that antiplatelet therapies have on patient mortality.

Link:In-Hospital Outcomes of Atherectomy During Endovascular Lower Extremity Revascularization, Panaich SS, et al.

Contemporary data on clinical outcomes after utilization of atherectomy in lower extremity endovascular revascularization are sparse. The study cohort was derived from Healthcare Cost and Utilization Project nationwide inpatient sample database from the year 2012.

Link:Vascular hospitalization rates and costs in patients with peripheral artery disease in the United States, Mahoney EM, et al.

 Peripheral artery disease (PAD) is common and imposes a high risk of major systemic and limb ischemic events. 

PDF:Acute limb ischemia and outcomes with vorapaxar in patients with peripheral artery disease: results from the trial to assess the effects of vorapaxar in preventing heart attack and stroke in patients with atherosclerosis-thrombolysis in myocardial infarct, Bonaca MP, et al.

Patients with peripheral artery disease (PAD) are at heightened risk of acute limb ischemia (ALI), a morbid event that may result in limb loss.

PDF:Cardiovascular outcomes in patients with peripheral arterial disease as an initial or subsequent manifestation of atherosclerotic disease: Results from a Swedish nationwide study, Sigvant B, et al.

Long-term progression of peripheral arterial disease (PAD) as initial manifestation of atherosclerotic arterial disease is not well described.

Link:Ticagrelor compared with clopidogrel in patients with prior lower extremity revascularization for peripheral artery disease, Jones WS, et al.

In patients with symptomatic peripheral artery disease with a history of limb revascularization, the optimal antithrombotic regimen for long-term management is unknown.

PDF:Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial, Belch JJ, et al.

Dual antiplatelet therapy with clopidogrel plus acetylsalicylic acid (ASA) is superior to ASA alone in patients with acute coronary syndromes and in those undergoing percutaneous coronary intervention.

PDF:Peripheral Artery Disease (PAD) is More Prevelant Among African American Populations

Review facts about the prevalence rate of PAD among the African American population.

PDF:Racial differences in primary and repeat lower extremity amputation: Results from a multihospital study, Feinglass J, et al.

This article analyzes two potential pathways for racial disparities: primary amputation, defined as a major amputation performed without any prior attempt at revascularization, and repeat amputation, defined as a major amputation subsequent to a previous through - foot or major amputation.

PDF:Dartmouth Atlas Report Series: How Diabetes & PAD Are Putting Patients at High Risk for Amputations.

This report, which uses 2007 - 2011 Medicare data, looks at the scope of diabetes and peripheral arterial disease in the U.S., with a focus on geographic variations in both preventative services and interventional, while recognizing the ultimate goal of avoiding amputation and preserving the ability to walk for patients.

Link:The clinical outcomes of triple antiplatelet therapy versus dual antiplatelet therapy for high-risk patients after coronary stent implantation: a meta-analysis of 11 clinical trials and 9,553 patients, Fan Z-G, et al.

The optimal antiplatelet regimen after in‑coronary intervention among patients presenting with complex coronary artery lesions or acute coronary syndrome (ACS) has remained unclear. This study sought to evaluate the clinical outcomes of triple antiplatelet treatment (TAPT) (cilostazol added to aspirin plus clopidogrel) in these patients.

Link:High mortality risks after major lower extremity amputation in Medicare patients with peripheral artery disease, Jones WS, et al.

Little is known regarding the contemporary outcomes of older patients with peripheral artery disease (PAD) undergoing major lower extremity (LE) amputation in the United States. The authors sought to characterize clinical outcomes and factors associated with outcomes after LE amputation in patients with PAD.

Treatment

Audio:Adherence to Medical Management for CAD and/or PAD: Patients and Providers, Communication and Connectivity Vehicles

Describe challenges in achieving optimal adherence to medical recommendations among patients with CAD and/or PAD, and means of increasing adherence through patient engagement.

Audio:Improving the Use of Prevention and Lifestyle Counseling in Patients with PAD

A review of current recommendations and research for managing the lifestyle risk factors of PAD

Link:Peripheral Artery Disease: Current Insight Into the Disease and Its Diagnosis and Management, Olin JW, et al.

This resource identifies the signs and symptoms of peripheral artery disease and distinguishes them from other diseases that can mimic PAD. Diagnose PAD using the history, findings on physical examination, and ankle brachial index, and formulate an integrated treatment program to improve the symptoms and quality of life and decrease the high cardiovascular event rate.

Audio:Dual Antiplatelet Therapy Following DES Placement: What is the Optimal Duration?

Discuss various studies that have assessed the optimal duration of DAPT following DES implanatation, and relate present recommendations.

PDF:Vitamin K antagonists with or without long-term antiplatelet therapy in outpatients with stable coronary artery disease and atrial fibrillation: Association with ischemic and bleeding events, Lemesle G, et al.

It remains uncertain whether patients with atrial fibrillation requiring longterm oral anticoagulation and with stable coronary artery disease should receive antiplatelet therapy in addition to oral anticoagulation.

Audio:Secondary Prevention of Atherothrombotic Events

Describing how physicians manage patients with prior atherothrombotic events in order to prevent further disease progression.

Audio:Update on Lifestyle Management for PAD and CAD-Wearable Devices, Apps, and Innovation

Assess the impact of digital technologies on patients with PAD and CAD, specifically focusing on the potential of new, wearable technologies that may induce positive changes in lifestyle that will reduce risk of adverse outcomes.

PDF:Aspirin and the risk of cardiovascular events in atherosclerosis patients with and without prior ischemic events, Bavry AA, et al.

The benefit of aspirin among patients with stable atherosclerosis without a prior ischemic event is not well defined. Aspirin is of benefit in outpatients with atherosclerosis with prior ischemic events, but not in those without ischemic events.

Link:Clopidogrel and Aspirin versus Aspirin Alone for the Prevention of Atherothrombotic Events, Bhatt DL, et al.

Dual antiplatelet therapy with clopidogrel plus low-dose aspirin has not been studied in a broad population of patients at high risk for atherothrombotic events.

Audio:Dual Antiplatelet Therapy After Coronary Stenting Among Patients With Peripheral Arterial Disease: A Subanalysis of the Dual Antiplatelet Therapy Study

Describe the overall study aims, and the methods of the subanalysis, and the results of the subanalysis focused on DAPT following PCI with stent implantation in patients with PAD.

Link:Variation in the Use of Lower Extremity Vascular Procedures for Critical Limb Ischemia, Goodney PP, et al.

Many believe that variation in vascular practice may affect limb salvage rates in patients with severe peripheral arterial disease. However, the extent of variation in procedural vascular care obtained by patients with critical limb ischemia (CLI) remains unknown.

PDF:Variation in the Care of Surgical Conditions: Diabetes and Peripheral Arterial Disease, Goodney PP, et al.

This Dartmouth Atlas of Health Care series reports on unwarranted regional variation in the care of several conditions for which surgery is one important treatment option.

PDF:Cost-Benefit Analysis of Critical Limb Ischemia in the Era of the Affordable Care Act, Yost ML.

During the past 15 years, the number of major dysvascular amputations (defined as amputations above the ankle) performed annually has decreased. However, major amputation (MA) continues to be a primary therapy and is frequently the only treatment offered for critical limb ischemia.

Link:The Safety and Efficacy of Peripheral Vascular Procedures Performed in the Outpatient Setting, Oskui PM, et al.

Peripheral vascular interventions have been traditionally performed in the inpatient setting. However, there has been a recent shift away from hospital-based vascular interventions toward outpatient-based procedures. Data are scarce on the efficacy and safety of such procedures being performed in the outpatient setting. This study evaluates the safety and efficacy of peripheral vascular interventions performed in a private, outpatient catheterization laboratory.

PDF:Collaborative meta­-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.

Read about the effects of antiplatelet therapy among patients at high risk of occlusive vascular events.

Link:Ticagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease, Hiatt WR, et al.

Peripheral artery disease is considered to be a manifestation of systemic atherosclerosis with associated adverse cardiovascular and limb events. Data from previous trials have suggested that patients receiving clopidogrel monotherapy had a lower risk of cardiovascular events than those receiving aspirin. The authors compared clopidogrel with ticagrelor, a potent antiplatelet agent, in patients with peripheral artery disease.

Link:Direct Xa inhibitors in addition to antiplatelet therapy in acute coronary syndrome: meta-analysis of randomized trials, Villablanca PA, et al.

The authors carried out a meta-analysis summarizing the efficacy and safety of direct factor Xa inhibitor (DXI) in patients receiving guideline-based antiplatelet therapy (GBAT) after an acute coronary syndrome.

PDF:Fifteen-Year Trends in Lower Limb Amputation, Revascularization, and Preventive Measures Among Medicare Patients, Goodney PP, et al.

Trends in the risk of amputation remain unexplored in recent years. The resource examines trends in lower extremity amputation rates, diagnostic and therapeutic vascular procedures, and the use of preventive measures aimed at limiting the use of amputation procedures in the United States between 1996 and 2011.

Audio:Interventions to Improve Health Behaviors Related to Coronary Artery Disease

Describing the various lifestyle interventions available to improve outcomes among patients with CAD and/or PAD.

PDF:African Americans and Peripheral Arterial Disease: A Review Article, Ghidei W, et al.

African Americans are more than twice as likely as non-Hispanic whites to suffer from PAD. Review the management of PAD in African Americans.

Link:Management of peripheral arterial disease of the lower extremities in elderly patients, Aronow WS.

The prevalence of peripheral arterial disease (PAD) increases with age. PAD in elderly persons may be asymptomatic, may be associated with intermittent claudication, or may be associated with critical limb ischemia.

Link:Comparative determinants of 4-year cardiovascular event rates in stable outpatients at risk of or with atherothrombosis, Bhatt DL, et al.

This article categorizes the risk of cardiovascular events in stable outpatients with various initial manifestations of atherothrombosis using simple clinical descriptors.

Link:A structured review of antithrombotic therapy in peripheral artery disease with a focus on revascularization: a TASC (InterSociety Consensus for the Management of Peripheral Artery Disease) initiative, Hess CN, et al.

Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality.

Link:Medical treatment of peripheral arterial disease, Hankey GJ, et al.

This article reviews the best evidence for medical treatment of PAD.

PDF: Antithrombotic therapy in peripheral artery disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines, Alonso-Coello P, et al.

This guideline focuses on antithrombotic drug therapies for primary and secondary prevention of cardiovascular disease as well as for the relief of lower-extremity symptoms and critical ischemia in persons with peripheral arterial disease (PAD).

Link:Long-term effect of chronic oral anticoagulation: focus on coronary artery disease, Lotrionte M, et al.

This review provides a succinct and updated appraisal of the long-term effects of chronic oral anticoagulation in the setting of coronary artery disease.

PDF:Antithrombotic Trialists’ Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.

This article determines the effects of antiplatelet therapy among patients at high risk of occlusive vascular events.

Link:The risks of PPI therapy, Moayyedi P, et al.

PPIs have become one of the most commonly used medications worldwide, as they are the treatment of choice for several acid-related gastrointestinal disorders. 

Link:Proton pump inhibitor use and the risk of chronic kidney disease, Lazarus B, et al.

Proton pump inhibitors (PPIs) are among the most commonly used drugs worldwide and have been linked to acute interstitial nephritis. Less is known about the association between PPI use and chronic kidney disease (CKD).

Link:Association of proton pump inhibitors with risk of dementia: a pharmacoepidemiological claims data analysis, Gomm W, et al.

Medications that influence the risk of dementia in the elderly can be relevant for dementia prevention. Proton pump inhibitors (PPIs) are widely used for the treatment of gastrointestinal diseases but have also been shown to be potentially involved in cognitive decline.

Link:Navigating the crossroads of coronary artery disease and heart failure, Gheorghiade M, et al.

Chronic heart failure (HF) affects 5 million patients in the United States and is responsible for &1 million hospitalizations and 300,000 deaths annually.

PDF:Antiplatelet therapy and other interventions after revascularisation procedures in patients with peripheral arterial disease: a meta-analysis, Girolami B, et al.

This article evaluates the efficacy of conservative adjuvant therapy after revascularisation procedures in patients with peripheral arterial disease.

Link:Evaluation of prasugrel compared with clopidogrel in patients with acute coronary syndromes: design and rationale for the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel Thrombolysis In Myocardial Infarction, Wiviott SD, et al.

Dual antiplatelet therapy with aspirin and clopidogrel is standard for prevention of thrombotic complications of percutaneous coronary intervention (PCI). 

Link:Ticagrelor for prevention of ischemic events after myocardial infarction in patients with peripheral artery disease, Bonaca MP, et al.

This study evaluated the efficacy and safety of ticagrelor on major cardiovascular (CV) events and major adverse limb events in patients with PAD and a prior MI.

Link:Oral anticoagulant and antiplatelet therapy and peripheral arterial disease, Anand S, et al.

Atherosclerotic peripheral arterial disease is associated with an increased risk of myocardial infarction, stroke, and death from cardiovascular causes. 

PDF:Vorapaxar in patients with peripheral artery disease: results from TRA2°P-TIMI 50, Bonaca MP, et al.

Vorapaxar is a novel antagonist of protease-activated receptor-1, the primary receptor for thrombin on human platelets that is also present on vascular endothelium and smooth muscle.

PDF:Clopidogrel with or without omeprazole in coronary artery disease, Bhatt DL, et al.

Gastrointestinal complications are an important problem of antithrombotic therapy. Proton-pump inhibitors (PPIs) are believed to decrease the risk of such complications, though no randomized trial has proved this in patients receiving dual antiplatelet therapy.

Link:Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events, Bhatt DL, et al.

Dual antiplatelet therapy with clopidogrel plus low-dose aspirin has not been studied in a broad population of patients at high risk for atherothrombotic events.

Link:Vorapaxar in the secondary prevention of atherothrombotic events, Morrow DA, et al.

Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1.

Link:Warfarin, aspirin, or both after myocardial infarction, Hurlen M, et al.

The role of antithrombotic therapy in secondary prevention after myocardial infarction is well established.

Link:Aspirin and coumadin after acute coronary syndromes (the ASPECT-2 study): a randomised controlled trial, van Es RF, et al.

Antiplatelet treatment with aspirin and oral anticoagulants reduces reocurrence of ischaemic events after myocardial infarction. 

Link:Oral anticoagulants in patients with coronary artery disease, Anand SS, et al.

Oral anticoagulants have been used in patients with vascular disease for over 40 years, yet their role in the secondary prevention of recurrent cardiovascular (CV) events remains controversial.

Link:Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal antiinflammatory drugs, antiplatelet agents, or anticoagulants, Lanas Á, et al.

Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin is associated with increased risk of upper gastrointestinal bleeding. 

Link:Telmisartan, ramipril, or both in patients at high risk for vascular events, Yusuf S, et al.

In patients who have vascular disease or high-risk diabetes without heart failure, angiotensin-converting–enzyme (ACE) inhibitors reduce mortality and morbidity from cardiovascular causes, but the role of angiotensin-receptor blockers (ARBs) in such patients is unknown.

Link:The use of antiplatelet therapy in the outpatient setting: Canadian Cardiovascular Society guidelines, Bell AD, et al.

Antiplatelet agents are a cornerstone of therapy for patients with atherosclerotic vascular disease. There is presently a lack of comprehensive guidelines focusing on the use of antiplatelet drugs in patients currently manifesting or at elevated risk of cardiovascular disease.

Audio:CVD Risk Management That Includes Both Pharmacologic and Non-pharmacologic Strategies with Changing Intensity and Modality

Describe how physicians manage cardiovascular risk, including therapies to reduce cholesterol, manage blood pressure, and reduce thromotic risk, as well as lifestyle changes such as smoking cessation, diet and exercise.

Link:Review of aspirin and clopidogrel resistance in peripheral arterial disease, Guirgis M, et al.

Aspirin resistance and clopidogrel resistance are terms used to describe a reduction in the medication's efficacy in inhibiting platelet aggregation despite regular dosing. This review gives context to the clinical role and implications of antiplatelet resistance in peripheral arterial disease.

Audio:Multi-faceted Intervention to Improve Patient Adherence to Antiplatelet Therapies Following Percutaneous Coronary Intervention: What Works?

Describing what is known about the challenges in maintaining patient adherence to medications following PCI, including approaches that are known to effectively improve patient adherence.

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