Effectiveness of Blood Lipid Management in Patients With Peripheral Artery Disease

Hess, Connie N.; Cannon, Christopher P.; Beckman, Joshua A.; Goodney, Philip P.; Patel, Manesh R.; Hiatt, William R.; Mues, Katherine E.; Orroth, Kate K.; Shannon, Erin; Bonaca, Marc P.

doi:10.1016/j.jacc.2021.04.060

Cited by 26 publications

(18 citation statements)

References 19 publications

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“…In the observational study of Hess et al, that included 250,103 patients with PAD, ~40% were not on any lipid-lowering therapy despite the observed increased risk of MALE and MACE. Similar to the prior observation, lipid-lowering therapies were used less often and at lower doses for PAD patients in contrast to coronary artery disease (CAD) patients who were more frequently prescribed high-intensity statins [ 53 ]. Colantonio et al, also noted similar findings in their database—although the risk of CV events in patients with PAD was comparable to those with CAD (HR 0.91, CI 0.86–0.95), the former was significantly less likely to have been prescribed statins.…”

Section: Role Of Statins In Padmentioning

confidence: 92%

Role of Lipid-Lowering Therapy in Peripheral Artery Disease

Belur

Shah

Virani

et al. 2022

JCM

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Atherosclerosis is a multifactorial, lipoprotein-driven condition that leads to plaque formation within the arterial tree, leading to subsequent arterial stenosis and thrombosis that accounts for a large burden of cardiovascular morbidity and mortality globally. Atherosclerosis of the lower extremities is called peripheral artery disease and is a major cause of loss in mobility, amputation, and critical limb ischemia. Peripheral artery disease is a common condition with a gamut of clinical manifestations that affects an estimated 10 million people in the United States of America and 200 million people worldwide. The role of apolipoprotein B-containing lipoproteins, such as LDL and remnant lipoproteins in the development and progression of atherosclerosis, is well-established. The focus of this paper is to review existing data on lipid-lowering therapies in lower extremity atherosclerotic peripheral artery disease.

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Section: Role Of Statins In Padmentioning

confidence: 92%

Role of Lipid-Lowering Therapy in Peripheral Artery Disease

Belur

Shah

Virani

et al. 2022

JCM

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“…We defined this cohort using the ICD-9 and ICD-10 codes for DM and PAD that have been used in contemporary studies to capture similar cohorts. 16 , 17 , 18 These codes were applied to 100% of Medicare claims (using MedPAR and carrier files) for 2003 through 2016, yielding a total of 10,505,853 unique encounters (the file was restricted to unique individuals to allow us to follow patients over time). We defined the first date on which a diagnosis code of DM was identified as time zero in our Kaplan-Meier analysis of lower extremity amputation.…”

Section: Resultsmentioning

confidence: 99%

Deriving International Classification of Diseases, 9th and 10th revision, codes for identifying and following up patients with diabetic lower extremity ulcers

Fowler¹,

Eid²,

Barnes³

et al. 2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…For example, one can estimate the reduction in future CVD events; if we shifted CAD patients from an LDL-C of approximately 99 mg/dL down to 60 mg/dL, we could reduce risk an additional 17% [ 3 ]. The opportunities for improvement in secondary prevention are even greater in the peripheral vascular disease population [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Low-Density Lipoprotein Cholesterol Levels in Coronary Artery Disease Patients: Opportunities for Improvement

Martin

Teklu

Mandieka

et al. 2022

Cardiology Research and Practice

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Background. We sought to characterize the level of LDL-C control and identify opportunities for improvement and characteristics of patients who were undertreated. Methods. Study patients were from a large multihospital system, age <90, with documentation of at least two encounters with a CAD diagnosis or procedure before a first measured LDL-C level and a last recorded LDL-C measurement over a minimum six-month (median = 22 months, IQR = 15–26 months) follow-up from January 2017 to September 2019. Linear regression analysis for last recorded LDL-C level was used to analyze the effects of statin intensity and patient characteristics. Results. Among 15,111 eligible patients, mean age was 68.4 (SD = 10.8), 68.7% were male, and 79.4% were non-Hispanic White. At follow-up, 87.8% of patients were prescribed a statin, 9.7% were on ezetimibe, and 0.5% were on a PCSK9 inhibitor. Mean LDL-C at follow-up was 75.6 mg/dL and 45.5% of patients were on high-intensity treatment. Higher LDL-C values were associated with female sex, younger patients, non-Hispanic Black patients, high poverty or out of state zip code, Medicaid, or angina as the qualifying diagnosis. For 332 clinicians with >10 patients in the cohort, mean last recorded LDL-C values ranged from 47 to 102 mg/dL. Conclusions. There were important variations in LDL-C control between patients in our health system with the same indication for treatment. Variation in treatment among physicians is an area ripe for quality improvement interventions. This study may be easily reproduced by other medical centers and used for highlighting both patient and physician opportunities for improvement.

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Effectiveness of Blood Lipid Management in Patients With Peripheral Artery Disease

Cited by 26 publications

References 19 publications

Role of Lipid-Lowering Therapy in Peripheral Artery Disease

Role of Lipid-Lowering Therapy in Peripheral Artery Disease

Deriving International Classification of Diseases, 9th and 10th revision, codes for identifying and following up patients with diabetic lower extremity ulcers

Low-Density Lipoprotein Cholesterol Levels in Coronary Artery Disease Patients: Opportunities for Improvement

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