Comparison of Lipid Management in Patients With Coronary Versus Peripheral Arterial Disease

Apr 28, 2014
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Authors:
Sharma S, Thapa R, Jeevanantham V, et al.
Citation:
Am J Cardiol 2014;113:1320-1325.
Summary By:
Prashant Vaishnava, MD, FACC

Study Questions:

What are differences in lipid control and statin use in patients with lower extremity peripheral arterial disease (PAD) versus those with coronary artery disease (CAD) or both CAD and PAD?

Methods:

This was a retrospective analysis from a single center. Electronic medical records from January 2009 to March 2012 were reviewed. Patients were categorized into three groups: CAD only, PAD only, or combined CAD and PAD. The percentage of patients with low-density lipoprotein (LDL) levels <100 and <70 mg/dl were compared among the three groups. The authors also compared statin use (and converted all statin doses to an equivalent potency unit) among the three groups.

Results:

Among 11,134 patients, mean LDL in the PAD group was higher than that in the CAD group (92 vs. 83 mg/dl, respectively, p < 0.001) and the combined CAD and PAD groups (92 vs. 80 mg/dl, respectively, p < 0.001). Compared with the CAD group, a lesser number of patients with PAD received statin therapy (76% vs. 100%, respectively, p < 0.001).

Conclusions:

The authors concluded that there were significant differences in lipid control and statin use in patients with CAD, compared to those with PAD.

Perspective:

The limitations of this retrospective analysis aside, the authors provided compelling evidence to suggest incomplete adherence to guideline-based medical therapy in patients with PAD. Such a finding is an opportunity to improve secondary prevention in this population.

Keywords: Lipoproteins, LDL, Electronic Health Records, Coronary Artery Disease, Secondary Prevention, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Peripheral Arterial Disease, Peripheral Vascular Diseases


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