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Improved Lipid Target Level Attainment in Patients with Peripheral Artery Disease

[ Vol. 19 , Issue. 6 ]

Author(s):

Jörn F. Dopheide*, Luise Adam, Sebastian Wiedmer, Mathias Kaspar, Günther Silbernagel, Iris Baumgartner* and Heinz Drexel*   Pages 634 - 642 ( 9 )

Abstract:


Background: Patients with peripheral artery disease (PAD) fall under the category of a very high cardiovascular risk. Although consequent lipid-lowering therapy (LLT) is advised, only sparse data on attained target level in PAD exists.

Objectives: We aimed to analyse contemporary guideline recommendations for LLT in symptomatic PAD patients.

Methods: A monocentric, prospective, observational study involving 200 symptomatic PAD patients was conducted. Guideline target level attainment and LLT were analysed between 2017 and 2019.

Results: Overall, 78.5% of the patients were on statin therapy, mainly of high intensity, with atorvastatin in 50% and rosuvastatin in 33% of the cases. The average statin dosage adjusted for simvastatin was 55 mg/d. Low density lipoprotein-cholesterol (LDL-C) was <1.8 mmol/L in 53% and <1.4 mmol/L in 34% of the cases. Mean LDL-C levels were at 1.85 ± 0.88 mmol/L. We observed no difference in the treatment and the target level attainment of patients with a stable PAD (intermittent claudication) or chronic critical PAD. However, patients with ≥ 1 vascular region affected (i.e., coronary and/or cerebrovascular) were treated more intensively and had lower LDL-C levels than patients with PAD alone.

Conclusion: It appears that there are more awareness and improvement of previously documented undertreatment of LDL-C levels in symptomatic PAD patients. Although statin treatment is initiated in the majority of patients, our findings call for a continuously intensified LLT in symptomatic PAD patients.

Keywords:

Peripheral artery disease, lipid-lowering therapy, statins, low-density lipoprotein-cholesterol, target attainment, cardiovascular risk.

Affiliation:

Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Department of Internal Medicine, Division of Angiology, Medical University of Graz, Graz, Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch

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