Oral Anticoagulant and Antiplatelet Therapy for Peripheral Arterial Disease: A Meta-Analysis of Randomized Controlled Trials

Abstract

A retrospective review of PubMed, Embase, Web of Science, and Cochrane Library for randomized controlled trials was performed from January 1, 1990 to June 1, 2020. Based on three randomized controlled trials of patients with peripheral arterial disease (PAD), oral anticoagulant plus antiplatelet therapy significantly improved acute limb ischemia, stroke, and major amputation events compared with antiplatelet agents alone. However, oral anticoagulant plus antiplatelet therapy was not effective for the prevention of myocardial infarction or death from any cause. Additionally, a significant increase in major bleeding events was demonstrated. This meta-analysis showed that oral anticoagulant plus antiplatelet therapy for PAD can improve the acute limb ischemia and major amputation or stroke risk compared with antiplatelet therapy alone but does not decrease the risk of myocardial infarction or death and might increase the risk of major bleeding events.