Aspirin as Good as Plavix for Poor Leg Circulation: Study

TUESDAY Feb. 21, 2012 -- Aspirin works as well as Plavix in patients with blocked leg arteries, a new European study finds.

People with the condition, called peripheral artery disease, often suffer from intermittent claudication, which is pain while walking because of decreased blood supply to the legs. Animal experiments had suggested that aspirin might block the growth of blood vessels that bypass blockages and help get more blood to leg tissue, the Swiss and German researchers said.

"Once again, we have shown that what happens in animals doesn't translate to humans," said Dr. Juan Zambrano, an assistant professor of cardiovascular medicine, coronary/endovascular and stem cell therapies at the University of Miami Miller School of Medicine.

Patients suffering from peripheral artery disease are also at increased risk of heart attack and stroke from blood clots traveling from the legs to the heart or brain, which is why these patients are given blood thinners such as Plavix (clopidogrel) or aspirin, explained Zambrano.

"Either aspirin or Plavix is acceptable as a good preventive measure to avoid heart attack or stroke in these patients," he said. "A lot of people favor aspirin because it's cheaper."

However, the most interesting part of this study to Zambrano was the role of exercise in improving walking distance and time.

"Something as simple as exercise can help improve claudication," he said. "Exercise is key and it doesn't matter how you treat the underlying condition, exercise is always going to help."

The report was published online Feb. 21 in the journal Cardiovascular and Cerebrovascular Disease.

For the study, a team led by Dr. Kurt Jaeger from University Hospital Basel in Switzerland, looked at the effectiveness of aspirin and Plavix in helping peripheral artery disease patients improve pain-free walking distance, which is a vital part of rehabilitation.

The researchers randomly assigned 229 patients to receive low-dose aspirin or Plavix, to see how they did during one hour walks.

Jaeger's group found that, after 12 weeks, people taking aspirin improved pain-free walking distance almost 40 percent and could walk 35 percent longer before pain made it too hard to continue.

For patients taking Plavix, there was a 33 percent improvement in walking distance and an almost 35 improvement in pain-free walking time, the researchers noted.

Walking is an important part of rehabilitation for peripheral artery disease patients. Walking can help increase blood flow to the legs and promote the growth of tiny blood vessels that help supply the leg with blood and oxygen.

It had been thought that aspirin wouldn't work because its anti-inflammatory properties could block the development of these tiny blood vessels that grow to get blood around the blockage.

"It seems that the anti-inflammatory properties of low-dose aspirin and its inhibiting effects on [the growth of new blood vessels] are not of clinical relevance for rehabilitation programs in intermittent claudication," the researchers concluded.

More information

For more on peripheral artery disease, visit the American Heart Association.

Posted: February 2012


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