Table 2.
Clinical trial | No. of patients | Patient population | Drugs studied | Primary end point | Outcomes |
COMPASS[44,45] (2017) | 27402 | Peripheral arterial disease or coronary artery disease | Rivaroxaban plus aspirin or rivaroxaban alone vs aspirin alone | Myocardial infarction, stroke, CV death and the time from randomization to the first occurrence of major bleeding | Preliminary results: Trial stopped prematurely. One of rivaroxaban arms proved to be superior to aspirin alone No disclosed information on the primary bleeding endpoint or the regimen that showed superiority to aspirin alone |
EUCLID[41] (2016) | 13885 | PAD (ABI ≤ 0.80 or prior (> 30 d) revascularization of the lower extremities) | Ticagrelor vs clopidogrel | CV death, MI, or ischemic stroke | 10.8% in ticagrelor group vs 10.6% in clopidogrel group (P = 0.65) |
MIRROR[39] (2012) | 80 | PAD treated with endovascular therapy | Dual antiplatelet therapy (aspirin plus clopidogrel) vs aspirin monotherapy | Local concentrations of platelet activation markers β-thromboglobulin and CD40L | Reduced peri-interventional platelet activation and improved functional outcome in the dual antiplatelet therapy group |
Berger et al[13] (Meta-analysis-2009) | 5269 | PAD (patients with claudication, those undergoing percutaneous intervention or bypass surgery, and asymptomatic patients with an ABI of 0.99 or less) | Aspirin or combination of aspirin plus dipyridamole vs placebo | Composite end point of non-fatal MI, nonfatal stroke, and CV death | 8.9% in aspirin or combination of aspirin and dipyridamole, 11% in placebo (95%CI: 0.76-1.04) |
WAVE[43] (2007) | 2161 | PAD (atherosclerosis of the arteries of lower extremities, carotid arteries or subclavian arteries) | Antiplatelet agent plus oral anticoagulant vs antiplatelet therapy in patients with PAD | CV death, MI and stroke | 12.2% in combination therapy group and 13.3% in antiplatelet therapy alone (95%CI: 0.73 to 1.16; P = 0.48) |
Thompson et al[29] (Meta-analysis-2002) | 2702 | PAD (stable, moderate to severe claudication) | Cilostazol vs placebo | MWD, pain free walking distance | MWD: 44% and 50% (cilostazol 50 mg and 100 mg respectively) and 21.4% in placebo (P < 0.05) Pain-free walking distance: 60% and 67% (cilostazol 50 and 100 mg respectively) and 40% in placebo group (P < 0.05) |
BOA[42] (2000) | 2690 | Patients undergone infra-inguinal bypass surgery | Warfarin vs aspirin | Graft occlusion | No observed difference in warfarin compared to aspirin (HR = 0.95; 95%CI: 0.82-1.11) |
ABI: Ankle brachial index; CV: Cardiovascular; HR: Hazard ratio; MI: Myocardial infarction; MWD: Mean walking distance.