What is the recommended initial antiplatelet therapy for a patient with peripheral artery disease according to the AHA/ACC guidelines?

The recommended initial antiplatelet therapy for a patient with peripheral artery disease (PAD) according to the AHA/ACC guidelines is aspirin 81 mg daily. This recommendation is based on extensive clinical evidence highlighting the efficacy of aspirin in reducing cardiovascular events in patients with PAD.

Aspirin acts by irreversibly inhibiting cyclooxygenase-1 (COX-1), which leads to decreased production of thromboxane A2, thus reducing platelet aggregation and thrombus formation. For patients with PAD, this is particularly important because they are at heightened risk for cardiovascular events such as heart attacks and strokes.

While the combination of aspirin and clopidogrel may be utilized in specific high-risk cases or in patients who have had a recent cardiovascular event, the general recommendation for initial therapy is aspirin alone. Other options mentioned, such as ticagrelor and vorapaxar, are not typically used as first-line therapies for PAD; rather, they are indicated under different clinical circumstances or in the context of specific patient populations.

In summary, initiating treatment for PAD with aspirin 81 mg daily is well-supported in clinical guidelines and reflects a standard approach to managing risk in these patients.