Key result
In a real-world cohort of 669 patients with PAD and AAA, 86% failed to achieve guideline-directed LDL-C targets, whereas modeling estimated that achieving these targets would yield a 10-year absolute cardiovascular risk reduction of 9% in PAD and 14% in AAA.
Why the study?
Despite increased cardiovascular mortality, patients with PAD and AAA are often suboptimally treated, and the survival benefits of target-based risk-factor modification needed quantification in light of the COVID-19 pandemic.
Cross-Sectional (n=669)
No
Patients with PAD and AAA are significantly undertreated regarding lipid-lowering and antithrombotic therapies, and achieving guideline-directed targets could substantially reduce their 10-year cardiovascular risk.
Background and Objectives: It is well established that patients with peripheral artery disease (PAD) as well abdominal aortic aneurysm (AAA) have an increased cardiovascular (CV) mortality. Despite this higher risk, PAD and AAA patients are often suboptimality treated. This study assessed the CV profile of PAD and AAA patients, quantifying the survival benefits of target-based risk-factors modification even in light of the COVID-19 pandemic. Materials and Methods: PAD and AAA patients admitted for any reason to the Vascular Unit from January 2019 to February 2020 were retrospectively analyzed. Biochemical and CV profiles as well as ongoing medical therapies were recorded. Benefits of CV risk-factors control were estimated using the SMART-REACH model. A follow-up visit during the year 2020 was scheduled. Results: A total of 669 patients were included. Of these, 190 showed AAA and 479 PAD at any stage. Only 54% of PAD and 41% of AAA patients were on lipid-lowering drugs with non-optimal low-density lipoprotein (LDL) levels for most of them. A better control of all modifiable CV risk-factors based on the current guidelines would offer an absolute risk reduction of the mean 10-year CV risk by 9% in PAD and 14% in AAA. Unfortunately, the follow-up visit was lost because of COVID-19 limitations. Conclusions: Lipid profiles of PAD and AAA patients were far from guideline-based targets, and medical management was suboptimal. In our center, the COVID-19 pandemic impacted on the strict surveillance required in these very high-risk patients. The achievement of guideline-based therapeutic targets would definitively confer additional significant benefits in reducing the CV risk in these patients.
No takes yet. Share an insight, caveat, or question.
Natale et al. (2021) conducted a cross-sectional in Peripheral Artery Disease and Abdominal Aortic Aneurysm (n=669). Current medical management of cardiovascular risk factors vs. Guideline-directed medical therapy targets (hypothetical) was evaluated on Current medical management of modifiable major cardiovascular risk factors, particularly lipid profile and antithrombotic therapy. In a real-world cohort of 669 patients with PAD and AAA, 86% failed to achieve guideline-directed LDL-C targets, whereas modeling estimated that achieving these targets would yield a 10-year absolute cardiovascular risk reduction of 9% in PAD and 14% in AAA.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: