Which regimen is used for pharmaceutical management of peripheral arterial disease (PAD)?

Which regimen is used for pharmaceutical management of peripheral arterial disease (PAD)?

• A. Low-dose aspirin, clopidogrel, rivaroxaban
• B. Warfarin alone
• C. Statin alone
• D. No antiplatelets

Answer: (A)

In peripheral arterial disease, preventing thrombotic events and limb ischemia relies on antithrombotic therapy that targets both platelets and the coagulation cascade. Aspirin reduces platelet activation and aggregation, clopidogrel blocks the ADP receptor on platelets for additional antiplatelet effect, and rivaroxaban at a low dose directly inhibits factor Xa to dampen thrombin formation. Evidence from trials in stable atherosclerotic disease, including PAD, shows that combining rivaroxaban with aspirin lowers major cardiovascular and limb events compared with aspirin alone, though it increases bleeding risk. In selected patients, adding additional antiplatelet therapy like clopidogrel can provide extra protection, leading to a regimen that includes low-dose aspirin, clopidogrel, and rivaroxaban. Alternatives like warfarin alone have not shown superior outcomes and carry more bleeding risk; relying on statin therapy alone or using no antiplatelet therapy does not adequately reduce thrombotic risk in PAD.

In peripheral arterial disease, preventing thrombotic events and limb ischemia relies on antithrombotic therapy that targets both platelets and the coagulation cascade. Aspirin reduces platelet activation and aggregation, clopidogrel blocks the ADP receptor on platelets for additional antiplatelet effect, and rivaroxaban at a low dose directly inhibits factor Xa to dampen thrombin formation. Evidence from trials in stable atherosclerotic disease, including PAD, shows that combining rivaroxaban with aspirin lowers major cardiovascular and limb events compared with aspirin alone, though it increases bleeding risk. In selected patients, adding additional antiplatelet therapy like clopidogrel can provide extra protection, leading to a regimen that includes low-dose aspirin, clopidogrel, and rivaroxaban. Alternatives like warfarin alone have not shown superior outcomes and carry more bleeding risk; relying on statin therapy alone or using no antiplatelet therapy does not adequately reduce thrombotic risk in PAD.