Diabetes News

BRIDGEWATER, N.J., and PRINCETON, N.J., Dec. 13 (PRNewswire-FirstCall) - Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) announced the first-ever U.S. guidelines for the diagnosis and treatment of peripheral arterial disease (P.A.D.), a serious medical condition that puts up to 12 million Americans at an increased risk for a heart attack or stroke(1). In the guidelines, the antiplatelet therapy Plavix® (clopidogrel bisulfate) is recommended for reducing the risk of heart attack, stroke or vascular death in patients with P.A.D. The group of drugs known as antiplatelet agents received a Class 1 recommendation in the guidelines. PLAVIX is the only antiplatelet therapy that has been approved by the U.S. Food and Drug Administration (FDA) to reduce the risk of atherothrombotic events in patients diagnosed with P.A.D.(2).
 
"These guidelines emphasize the need to properly identify patients at risk for P.A.D. and provide physicians with recommendations for early diagnosis and consistent treatment of this disease and its associated risk of heart attack and stroke," said Dr. Peter Sheehan, Director, Diabetes Foot and Ankle Center, Hospital for Joint Diseases Orthopaedic Institute, New York, NY*. "An effective treatment recommended in the guidelines is antiplatelet therapy with PLAVIX, which helps to keep blood platelets from sticking together and forming clots, and has been shown to reduce the risk of a heart attack or stroke in patients who have been diagnosed with P.A.D."

P.A.D. is a chronic condition in which the arteries in the legs become narrowed or clogged due to the formation of plaque, restricting the flow of oxygen-rich blood(3). Poor blood circulation can cause pain in the legs while walking. People with P.A.D. may also have restricted circulation in the arteries of the heart or brain(3,4). If the arteries supplying blood to the heart or brain become blocked, it can result in a heart attack or stroke(5).

P.A.D., like diabetes, is a cardiovascular disease risk equivalent(6). People with P.A.D. run a high risk of suffering atherothrombotic events. In fact, these people are six times more likely to die from cardiovascular disease within 10 years than those without P.A.D.(7).

Some people with P.A.D. may have pain or discomfort in the buttocks, thighs or calves after walking a certain distance. This pain is called intermittent claudication and may be relieved by rest. However, most people with P.A.D. do not experience any symptoms at all -- only about one in three people with P.A.D. have leg pain(8).

Those most at risk for the disease include people over 50 with diabetes, smokers over 50, people over 70, people with high blood pressure and/or high cholesterol and those with a family history of heart attack or stroke(3,8). People with diabetes under 50 with one additional cardiovascular risk factor are also at an increased risk for P.A.D.(2).

P.A.D. can be diagnosed by a simple test called the ankle-brachial index (ABI). The ABI is used to determine a patient's blood pressure at the ankle and the arm. A positive P.A.D. diagnosis is confirmed when the pressure at the ankle is lower than the pressure at the arm(8).


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