Recent guidelines of the AHA/ACC 2016 and ESC 2017 on the treatment of PAOD
| Drugs groups | Society |
| Lipid-lowering drugs | |
| Statins are recommended in all patients with PAOD | ESC 2017 |
| In patients with intermittent claudication, on top of general prevention, statins are indicated to improve walking distance | ESC 2017 |
| Treatment with a statin medication is indicated for all patients with PAOD | AHA/ACC 2016 |
| Antithrombotics | |
| Antiplatelet therapy with aspirin alone (range 75–325 mg per day) or clopidogrel alone (75 mg per day) is recommended to reduce MI, stroke and vascular death in patients with symptomatic PAOD | AHA/ACC 2016 |
| In patients with PAOD and AF, OAC is recommended when the CHA2DS2-VASc score is ≥2 | ESC 2017 |
| Cilostazol is an effective therapy to improve symptoms and increase walking distance in patients with claudication. | AHA/ACC 2016 |
| Long-term single-antiplatelet treatment (clopidogrel 75 mg/day or aspirin 75–100 mg/day) is recommended in patients with symptomatic PAOD | ESC 2017 |
| Antiplatelet therapy is recommended in patients with symptomatic PAOD | ESC 2017 |
| Long-term single-antiplatelet treatment (clopidogrel 75 mg/day or aspirin 75–100 mg/day) is recommended in all patients who have undergone revascularisation | ESC 2017 |
| In patients with PAOD who have an indication for OAC (AF, mechanical prosthetic valve), oral anticoagulants alone should be considered | ESC 2017 |
| Vitamin K antagonists may be considered after autologous vein infra-inguinal bypass | ESC 2017 |
| In patients with ALI, systemic anticoagulation with heparin should be administered unless contraindicated. | AHA/ACC 2016 |
| Antihypertensives | |
| In patients with PAOD and hypertension, it is recommended to control blood pressure at <140/90 mm Hg | ESC 2017 |
| Antihypertensive therapy should be administered to patients with hypertension and PAOD to reduce the risk of MI, stroke, heart failure, and cardiovascular death | AHA/ACC 2016 |
| The use of ACEi or angiotensin-receptor blockers can be effective to reduce the risk of cardiovascular ischaemic events in patients with PAOD | AHA/ACC 2016 |
| ACEi or angiotensin-receptor blockers should be considered as first-line therapy in patients with PAODs and hypertension | ESC 2017 |
| ACEi or ARBs should be considered as first-line therapy in patients with PAOD and hypertension | ESC 2017 |
ACC, American College of Cardiology; ACEi, ACE inhibitors; AF, atrial fibrillation; AHA, American Heart Association; ALI, acute limb ischaemia; ARBs, angiotensin-receptor blockers; CHA2DS2-VASc, congestive heart failure, hypertension, age, diabetes mellitus, stroke/TIA, vascular disease, age, sex category; ESC, European Society for Cardiology; LEAD, lower extremity artery disease; MI, myocardial infarction; OAC, oral anticoagulants; PAODs, peripheral arterial occlusive disease; SAPT, single-antiplatelet treatment; TIA, transient ischaemic attack.