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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Dopheide, Jörn Fredrik; Schindewolf, Marc; Baumgartner, Iris and Drexel, Heinz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1933-2874

Publisher:

Elsevier

Language:

English

Submitter:

Isabel Lorenz

Date Deposited:

20 Nov 2019 09:13

Last Modified:

20 Nov 2019 09:13

Publisher DOI:

10.1016/j.jacl.2018.02.013

PubMed ID:

29574071

Uncontrolled Keywords:

LDL cholesterol Lipid targets Lipid-lowering therapy Peripheral arterial disease Statin adherence

BORIS DOI:

10.7892/boris.134565

URI:

https://boris.unibe.ch/id/eprint/134565

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