Title:Improved Lipid Target Level Attainment in Patients with Peripheral Artery Disease
Volume: 19
Issue: 6
Author(s): Jörn F. Dopheide*, Luise Adam, Sebastian Wiedmer, Mathias Kaspar, Günther Silbernagel, Iris Baumgartner*Heinz Drexel*
Affiliation:
- Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern,Switzerland
- Division for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern,Switzerland
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch,Austria
Keywords:
Peripheral artery disease, lipid-lowering therapy, statins, low-density lipoprotein-cholesterol, target attainment, cardiovascular
risk.
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.
