RT Book, Section
A1 Walsh, Michael
A1 Perkovic, Vlado
A1 Manns, Braden
A1 Srinathan, Sadeesh
A1 Meade, Maureen O.
A1 Devereaux, PJ
A1 Guyatt, Gordon
A2 Guyatt, Gordon
A2 Rennie, Drummond
A2 Meade, Maureen O.
A2 Cook, Deborah J.
SR Print(0)
ID 1193374388
T1 Therapy (Randomized Trials)
T2 Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179071-0
LK jamaevidence.mhmedical.com/content.aspx?aid=1193374388
RD 2024/04/19
AB CLINICAL  SCENARIOA  Patient  With  Peripheral  Artery  Disease:  How  Can  I  Improve  Physical  Function  and  Walking?You  are  a  general  internist  following  up  a  62-year-old  man  with  a  history  of  type  2  diabetes  mellitus,  hypertension,  and  hyperlipidemia  who  is  taking  oral  hypoglycemics,  a  statin,  and  a  thiazide-like  diuretic.  A  vascular  surgeon  recently  evaluated  the  patient  for  intermittent  claudication  and  made  a  diagnosis  of  peripheral  artery  disease.  The  surgeon  prescribed  low-dose  aspirin  and  pentoxifylline  to  reduce  the  patient's  risk  of  vascular  events  and  improve  his  ability  to  walk,  citing  2  systematic  reviews:  a  review  of  antiplatelet  agents  in  peripheral  artery  disease  that  found  a  decrease  in  the  odds  of  vascular  events  (odds  ratio  [OR],  0.78;  95%  confidence  interval  [CI],  0.63-0.96)  and  an  increase  in  walking  distance  of  59  m  (95%  CI,  37-81  m)  and  another  review  of  pentoxifylline  in  peripheral  artery  disease  that  increased  maximum  walking  distance  by  59  m  (95%  CI,  37-81  m).1,2  Despite  the  new  treatments,  the  patient  is  unable  to  walk  more  than  2  minutes  without  pain  and  finds  his  quality  of  life  substantially  impaired.Listening  to  the  patient's  story  of  poor  response  to  treatment  and  ongoing  symptoms,  you  recall  seeing  an  article  that  may  be  relevant.  You  ask  him  to  return  in  a  week  for  further  review  of  his  medications.