1. We recommend multidisciplinary comprehensive smoking cessation interventions for patients with IC (repeatedly until tobacco use has stopped) (Grade 1, Level A).
  2. We recommend statin therapy in patients with symptomatic PAD (Grade 1, Level A).
  3. We recommend optimizing diabetes control (hemoglobin A1c goal of <7.0%) in patients with IC if this goal can be achieved without hypoglycemia (Grade 1, Level B).
  4. We recommend the use of indicated β-blockers (eg, for hypertension, cardiac indications) in patients with IC. There is no evidence supporting concerns about worsening claudication symptoms (Grade 1, Level B).
  5. In patients with IC due to atherosclerosis, we recommend antiplatelet therapy with aspirin (75-325 mg daily) (Grade 1, Level A).
  6. We recommend clopidogrel in doses of 75 mg daily as an effective alternative to aspirin for antiplatelet therapy in patients with IC (Grade 1, Level B).
  7. In patients with IC due to atherosclerosis, we suggest against using warfarin for the sole indication of reducing the risk of adverse cardiovascular events or vascular occlusions (Grade 1, Level C).
  8. We suggest against using folic acid and vitamin B12 supplements as a treatment of IC (Grade 2, Level C).
  9. In patients with IC who do not have congestive heart failure, we suggest a 3-month trial of cilostazol (100 mg twice daily) to improve pain-free walking (Grade 2, Level A).
  10. In patients with IC who cannot tolerate or have contraindications for cilostazol, we suggest a trial of pentoxifylline (400 mg thrice daily) to improve pain-free walking (Grade 2, Level B).
  11. The Society’s committee charged with developing guidelines for atherosclerotic occlusive disease of the lower extremities has decided to strike recommendation 4.11 based on the current state of evidence after a randomized controlled trial that compared ramipril to a matching placebo was recently retracted. For a detailed explanation, please refer to the Supplementary Material in this Guideline’s PDF as part of this App or online at http://vsweb.org/LEPAD16.

ACEI, Angiotensin-converting enzyme inhibitor; PAD, peripheral arterial disease.