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Abstract Aim This study explored the prevalence, intensity, and trend of antithrombotic therapy (ATT) and LLT, and lipid profile monitoring around carotid intervention. Method This was a retrospective, single centre, time-series study of 260 symptomatic patients who underwent underwent CEA or CAS from 01/01/17–31/12/21 in a major regional vascular unit. Trend of antithrombotic therapy (ATT) and LLT from a pre-admission, surgery, discharge and 1-year post-procedure were analyzed to identify time points and subgroups requiring optimization. All data were collected from electronic hospital records linked to real-time primary care data with co-morbidities coded. Caldicott approval for consent from the local hospital was obtained. Results Prior to admission, 83% of patients were not prescribed ATT of whom 20% should have been. Similarly, 82% of patients were not prescribed LLT of whom 89% had a QRISK310% so should have been on primary prevention, and 36% should have been on secondary prevention. At discharge from hospital, 100% of patients were prescribed ATT. There was a failure to uptitrate LLT from discharge to one year follow up with no significant difference in LLT prescriptions. LDL level improved from a median LDL of 2.6mmol/L pre-admission to 1.7mmol/L at 1 year follow up. Conclusions To conclude, the study shows that there are significant improvements that should be made regarding medical management of carotid surgery patients including greater use of primary prevention in the community, earlier administration of ATT and the need for improved LDL control with greater use of ezetimibe and uptitration of statins post-procedure.
Harper et al. (Mon,) studied this question.