Antithrombotic Therapy in Peripheral Artery Disease: Generating and Translating Evidence Into Practice

J Am Coll Cardiol. 2018 Jan 23;71(3):352-362. doi: 10.1016/j.jacc.2017.11.021.


Atherosclerotic cardiovascular (CV) disease remains a major health concern affecting more than 200 million adults worldwide, and lower extremity peripheral artery disease (PAD) is associated with significant morbidity and mortality. Treatment strategies to reduce the burden of major adverse CV events and limb events have mainly involved the use of antiplatelet and statin medications. Unlike other types of atherosclerotic CV disease, the evidence base is not well developed for therapies in patients with PAD. Recently, studies from subgroups of patients with PAD and a large clinical trial of PAD patients have been published, signaling a burgeoning interest in studying this higher risk population. This review outlines the inherent CV risks of patients with PAD, risk reduction strategies, emerging clinical trial data, and opportunities for the CV community to generate evidence in real-world settings and translate evidence into practice as new therapies become available.

Keywords: antithrombotic therapy; clinical trials; peripheral artery disease; real-world evidence.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic / methods
  • Evidence-Based Medicine / methods*
  • Evidence-Based Medicine / trends
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Mortality / trends
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / drug therapy*
  • Peripheral Arterial Disease / mortality
  • Translational Medical Research / methods*
  • Translational Medical Research / trends


  • Fibrinolytic Agents