The effects on clinical outcomes of administering medications together or separately in prolonged dual antiplatelet therapy after peripheral revascularisation.

Abstract

Background: In the current guidelines, dual antiplatelet therapy [acetylsalicylic acid (ASA) + clopidogrel] is recommended for at least three months after peripheral iliac stenting. In this study, we investigated the effect on clinical outcomes of adding ASA in different doses and at different times after peripheral revascularisation.

Methods: Seventy-one patients were administered dual antiplatelet therapy after successful iliac stenting. Group 1, consisting of 40 patients, was given 75 mg of clopidogrel plus 75 mg of ASA in a single dose in the morning. In group 2, separate doses of 75 mg of clopidogrel (in the morning) and 81 mg of 1 × 1 ASA (in the evening) were started in 31 patients. The demographic data and bleeding rates of the patients after the procedure were recorded.

Results: The groups were found to be similar in terms of age, gender and accompanying co-morbid factors (p > 0.05). The patency rate was 100% in the first month in both groups, and it was above 90% at the sixth month. When one-year patency rates were compared, although the first group had higher rates (85.3%), no significant difference was found (p < 0.05). However, there were 10 (24.4%) bleeding events in group 1, and five (12.2%) of these were in the gastrointestinal system, resulting in reduced haemoglobin levels (p = 0.038).

Conclusion: ASA doses of 75 mg or 81 mg did not affect one-year patency rates. However, higher bleeding rates were observed in the group that received both clopidogrel and ASA treatment simultaneously (in the morning) despite the lower dose of ASA.