Cholesterol-lowering therapy in patients with symptomatic peripheral arterial disease – real life data in a German population

Summary: Background: Several studies have shown LDL-Cholesterol to be a main risk-factor in the development of atherosclerosis and that the reduction of LDL-Cholesterol leads to a substantial decrease in cardiovascular morbidity and mortality. Patients with proven PAD are considered to be at very high risk for cardiovascular events and a reduction of LDL-Cholesterol to 55 mg/dl and to 50% of the baseline is recommended in this population. Material and methods: Patients with symptomatic PAD from 7 Vascular Surgery Centres in Germany were included in the study. It was assessed if the patients were on Cholesterol-lowering drugs at admission and the Cholesterol und LDL-Cholesterol levels upon admission were obtained. A total of 884 patients were included in the analysis. Results: Only 537 (61%) patients were on Cholesterol-lowering drug therapy. In this subgroup, Cholesterol levels ≤ 100 mg/dl were found in 384 cases (72%), ≤ 70 mg/dl in 191 (36%) and ≤ 55 mg/dl in 87 (16%) of cases. Conclusions: Despite overwhelming evidence for the beneficial effects of adequate LDL-Cholesterol reduction, only 61% of PAD-patients were on Cholesterol-lowering drug therapy and only 16% achieved the LDL-Cholesterol levels advocated inn recent guidelines. The vascular community must undertake a bigger effort to implement Cholesterol-lowering drug therapy in PAD patients.