401 Cardiovascular Risk Factor Optimisation Amongst Inpatients with Peripheral Artery Disease – a Single-Centre Audit

Aim Patients with symptomatic peripheral artery disease (PAD) are highly co-morbid and thus may benefit from cardiovascular disease risk factors optimisation at the time of admission. This audit aimed at reviewing adherence to NICE guidelines for secondary prevention of cardiovascular disease amongst hospital in patients with critical limb-threatening ischaemia (CLTI) or intermittent claudication (IC). Method A retrospective review of all CLTI or IC inpatient admissions to a tertiary referral vascular surgery centre, over 9 months, was performed. We assessed adherence to five NICE recommendations for cardiovascular risk factor optimisation: 1) smoking cessation 2) lipid modification 3) antiplatelet therapy 4) blood pressure control 5) diabetes risk assessment, with target adherence of 100%. Results 97 admissions for PAD were recorded (CLTI n=87, 89.7%; IC n=10, 10.3%). The average age was 70.8±11.7 years, and 68.4% were male. Smoking cessation service was provided to 40.5% of eligible patients, lipid modification to 18.8%, blood pressure control to 29.5%, diabetes risk assessment to 21.1%, and antiplatelet therapy to 38.9%. Admissions longer than 10 days had a significantly higher rate of adherence (>10 days 35.5% vs ≤10 days 19.8%, p=0.017). Conclusions There are gaps in risk factor optimisation amongst PAD inpatients, with risk factors either not documented, or addressed appropriately. Shorter, elective hospital admissions were associated with worse risk factor optimisation. A dedicated review of risk factors should be offered to all PAD inpatients early during their admission. To achieve the best long-term adherence, multidisciplinary engagement of geriatrics, smoking cessation, diabetes, and primary care is essential.