Journal article
Poor attainment of lipid targets in patients with symptomatic peripheral artery disease.
- Dopheide JF Clinic for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Papac L Clinic for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Schindewolf M Clinic for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Baumgartner I Clinic for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Drexel H Clinic for Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria; Private University of the Principality of Liechtenstein, Principality of Liechtenstein, Triesen, Liechtenstein; Drexel University College of Medicine, Philadelphia, PA, USA. Electronic address: heinz.drexel@extern.insel.ch.
- 2018-03-26
Published in:
- Journal of clinical lipidology. - 2018
LDL cholesterol
Lipid targets
Lipid-lowering therapy
Peripheral arterial disease
Statin adherence
Aged
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipids
Male
Peripheral Arterial Disease
Survival Analysis
Time Factors
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jacl.2018.02.013
- PMID 29574071
- Persistent URL
- https://sonar.ch/global/documents/278741
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