ESC/WCC: No Peripheral Arterial Disease Benefit for Coumadin-Aspirin

BARCELONA, Spain, Sept. 6 -- An antiplatelet-anticoagulant duo, which showed promise in treating coronary disease, increased the risk of life-threatening bleeding events in patients with peripheral arterial disease, according to results of a trial reported here.

Four percent of patients randomized to Coumadin (warfarin) plus aspirin had life-threatening bleeding events versus 1.2% of patients treated with aspirin alone (P

The WAVE study recruited 2,161 patients and evenly randomized them to the Coumadin-plus-aspirin regimen or aspirin alone. The average age of patients was 64, and 74% were women. Twenty-nine percent of the participants were current smokers, and 81% had limb peripheral arterial disease. The average blood pressure in both arms was 137/78 mm Hg. At baseline, 98% of the participants were on antiplatelet therapy.

In each group treatment was titrated to reach International Normalization Ratio (INR) levels of 1.8 to 3.5.