Evidence map›Paper›PMID 22315275›Full record

GuidelineChest2012

Antithrombotic therapy in peripheral artery disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Pablo Alonso-Coello, Sergi Bellmunt, Catherine McGorrian, Sonia S Anand, Randolph Guzman, Michael H Criqui, Elie A Akl, Per Olav Vandvik, Maarten G Lansberg, Gordon H Guyatt and 1 more

Registry-linked trialAbstract readPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Chest, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04229264 (Efficacy and Safety of Apixaban in Reducing Restenosis and Limb Loss in Subjects With Symptomatic Peripheral Artery Disease), which is not on this map. Cited by 72 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04229264 phase3unknown statusnot on this mapstarted 2020, after this paper: background citation

Efficacy and Safety of Apixaban in Reducing Restenosis and Limb Loss in Subjects With Symptomatic Peripheral Artery Disease (PAD) Undergoing Infrapopliteal Endovascular Peripheral Revascularization Procedures in Patients With Critical Limb

TypeinterventionalSponsorScience Valley Research InstituteRan2020 to 2022Enrolled200ConditionsCritical Limb IschemiaArmsApixaban, ASA, Clopidogrel 75mg
3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Guideline
  8. Pooled it
  9. Guideline
  10. Guideline
  11. Prospective Single-Arm Trial of Endovascular Mechanical Debulking as Initial Therapy in Patients With Acute and Subacute Lower Limb Ischemia: One-Year Outcomes.Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2019
    Trial
  12. Edoxaban Plus Aspirin vs Dual Antiplatelet Therapy in Endovascular Treatment of Patients With Peripheral Artery Disease: Results of the ePAD Trial.Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2018
    Trial
  13. Article
  14. Article
  15. Review
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article

12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Pablo Alonso-CoelloIberoamerican Cochrane Centre, CIBERESP-IIB Sant Pau, Barcelona, Spain.
Sergi BellmuntAngiology, Vascular and Endovascular Surgery Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Catherine McGorrianThe Heart House, Mater Misericordiae University Hospital, Dublin, Ireland.
Sonia S AnandDepartment of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Randolph GuzmanDepartment of Section Vascular Surgery, University of Manitoba, St Boniface Hospital, Winnipeg, MB, Canada.
Michael H CriquiDepartment of Family and Preventive Medicine, University of California San Diego School of Medicine, La Jolla, CA.
Elie A AklDepartment of Medicine, State University of New York at Buffalo, Buffalo, NY.
Per Olav VandvikNorwegian Knowledge Centre for the Health Services and Department of Medicine Gjøvik, Innlandet Hospital Trust, Gjøvik, Norway.
Maarten G LansbergStanford Stroke Center, Stanford University Medical Center, Palo Alto, CA.
Gordon H GuyattDepartment of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Frederick A SpencerDepartment of Medicine, McMaster University, Hamilton, ON, Canada. Electronic address: fspence@mcmaster.ca.

Funding

Antithrombotic Therapy and Prevention of Thrombosis: ACCP Evidence-Based ClinicalR13HL104758 · NHLBI · AMERICAN COLLEGE OF CHEST PHYSICIANS · PI LEWIS, SANDRA ZELMAN · 2010 to 2010
$11k
NHLBI NIH HHS R13 HL104758
6 · The paper itself

Abstract

backgroundThis 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).

methodsThe methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement.

resultsThe most important of our 20 recommendations are as follows. In patients aged ≥ 50 years with asymptomatic PAD or asymptomatic carotid stenosis, we suggest aspirin (75-100 mg/d) over no therapy (Grade 2B) for the primary prevention of cardiovascular events. For secondary prevention of cardiovascular disease in patients with symptomatic PAD (including patients before and after peripheral arterial bypass surgery or percutaneous transluminal angioplasty), we recommend long-term aspirin (75-100 mg/d) or clopidogrel (75 mg/d) (Grade 1A). We recommend against the use of warfarin plus aspirin in patients with symptomatic PAD (Grade 1B). For patients undergoing peripheral artery percutaneous transluminal angioplasty with stenting, we suggest single rather than dual antiplatelet therapy (Grade 2C). For patients with refractory claudication despite exercise therapy and smoking cessation, we suggest addition of cilostazol (100 mg bid) to aspirin (75-100 mg/d) or clopidogrel (75 mg/d) (Grade 2C). In patients with critical limb ischemia and rest pain unable to undergo revascularization, we suggest the use of prostanoids (Grade 2C). In patients with acute limb ischemia due to acute thrombosis or embolism, we recommend surgery over peripheral arterial thrombolysis (Grade 1B).

conclusionsRecommendations continue to favor single antiplatelet therapy for primary and secondary prevention of cardiovascular events in most patients with asymptomatic PAD, symptomatic PAD, and asymptomatic carotid stenosis. Additional therapies for relief of limb symptoms should be considered only after exercise therapy, smoking cessation, and evaluation for peripheral artery revascularization.

Indexed as

Evidence-Based MedicineSocieties, MedicalAgedAngioplastyArterial Occlusive DiseasesCarotid StenosisCombined Modality TherapyDrug Therapy, CombinationFibrinolytic AgentsHumansIschemiaLegMiddle AgedPlatelet Aggregation InhibitorsSecondary PreventionThrombolytic TherapyFibrinolytic AgentsPlatelet Aggregation Inhibitors

Identifiers

PMID22315275
PMCPMC3278062

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.