2020년 Vol.37 No.02
Background : Arteriosclerosis obliterans (ASO) is a peripheral arterial obstructive disease that presents symptoms of cryesthesia (a feeling of chill in the feet and especially the toes) with walking and resting pain. However, there are no definitive treatments for ASO and there are still insufficient guidelines for the use of antiplatelet drugs which have been used for the treatment of ASO. Some studies have shown risk of bleeding from aspirin, a representative antiplatelet agent, in the Asian population. Thus, the purpose of this study was to analyze the efficacy and safety of aspirin and sarpogrelate administered for the treatment of ASO in Korea.
Methods : We retrospectively reviewed the electronic medical records of adult outpatients with ASO administered aspirin or sarpogrelate at a tertiary hospital January 2012 July 2019. Patients in this study were followed up to 12 months after the start of treatment. The incidence of revascularization and the changes in low-density lipoprotein cholesterol, high-density lipoprotein
cholesterol, triglyceride, total cholesterol, and glycated hemoglobin levels were compared for effect analysis. For safety analysis, we investigated the occurrence of drug-related bleeding (hematuria, hemoptysis, nose bleeding, and gastrointestinal bleeding) and drug-related adverse events (nasopharyngitis, heartburn, headache, abdominal pain, chest pain, and liver dysfunction).
Results : Of 62 patients, 24 (39%) were in the aspirin group and 38 (61%) were in the sarpogrelate
group. Two patients (8.3%) underwent percutaneous angioplasty within one year after aspirin administration, but none in the sarpogrelate group (p=0.15) underwent such a procedure. Drug-related bleeding occurred in three patients (7.9%) (p=0.28) and abdominal pain occurred in four patients (10.5%) (p=0.15) in the sarpogrelate group but none in the aspirin group.
Conclusion : The efficacy and safety were not significantly different between aspirin and sarpogrelate treatments in patients with ASO. Further prospective studies comparing aspirin and sarpogrelate among larger population, however, are needed.