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PAD-Antiplatelet Therapy — EECC MCQ

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HardCardiologyPAD-Antiplatelet TherapyEECC

A patient with intermittent claudication remains limited after supervised exercise and risk-factor optimisation. Cilostazol is being considered, but LVEF is 30%. What is the best alternative pharmacological option in UK practice?

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Correct answer: EA monitored trial of naftidrofuryl

Cilostazol is contraindicated in heart failure. NICE permits naftidrofuryl for selected people with intermittent claudication when exercise has not provided sufficient improvement and revascularisation is inappropriate or declined, with continuation only if meaningful benefit occurs. Drug therapy does not replace smoking cessation, exercise and vascular risk reduction. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: NICE CG147: peripheral arterial disease. https://www.nice.org.uk/guidance/cg147/chapter/recommendations