Poor attainment of lipid targets in patients with symptomatic peripheral artery disease.

Dopheide, Jörn F.; Papac, Lucija; Schindewolf, Marc; Baumgartner, Iris; Drexel, Heinz (2018). Poor attainment of lipid targets in patients with symptomatic peripheral artery disease. Journal of clinical lipidology, 12(3), pp. 711-717. Elsevier 10.1016/j.jacl.2018.02.013

Text Dopheide_poor attainment.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (651kB)

BACKGROUND

Patients with peripheral artery disease (PAD) are at very high risk of future cardiovascular (CV) events. Strict lipid-lowering therapy is recommended. However, data on target level attainment are scarce.

OBJECTIVE

The objective of the study was to investigate guideline equitable lipid lowering in a large observational study of symptomatic PAD patients.

METHODS

Single-center observational study including 1109 patients with symptomatic PAD planned for revascularization at a tertiary university center. Between 2010 and 2017, guideline target level attainment trends over time and the association of statin therapy with CV mortality were analyzed.

RESULTS

Atorvastatin (52.3%) and rosuvastatin (23.5%) were the most frequently prescribed statins and amounted to an average simvastatin equivalent of 52 mg/d. Attainment rates of low-density lipoprotein cholesterol (LDL-C) and of non-high-density lipoprotein cholesterol goals were as low as 27% and 33%, respectively. Although there was a significant improvement of LDL-C from 2010 to 2017 (mean LDL-C 110 vs 80 mg/dL, P < .0001 for trend), attainment remained poor, that is, only 42% in 2016 and 45% in 2017 achieved the <70 mg/dL goal. CV mortality was significantly lower (4% vs 11%, P < .01) in statin-treated patients over a median follow-up period of 50 ± 26 months.

CONCLUSION

There is a remarkable undertreatment of LDL-C and non-high-density lipoprotein cholesterol in patients with symptomatic PAD, although LDL-C decreased significantly from 2010 to 2017. As statin treatment was associated with a reduced CV mortality rate, our findings call for an increased awareness in clinical lipidology regarding symptomatic PAD patients.

Interest & Impact

Downloads

2 since deposited on 20 Nov 2019
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item