New 2026 ACC/AHA Clinical Performance and Quality Measures for Patients With Peripheral Artery Disease (PAD), released in collaboration with nine other specialty societies, offer a comprehensive framework to assess and elevate PAD care across clinical settings.

"These measures will help patients, clinicians, researchers, quality assurance personnel, payers, and regulatory agencies evaluate PAD care similarly and properly focus attention toward ensuring that high-quality, high-value care is delivered to all patients," according to Writing Committee Chair Philip P. Goodney, MD, MS, and Vice Chair Elsie G. Ross, MD, MS, RPVI.

A total of 15 measures – seven performance measures and eight quality measures – are defined in the document and based on the 2024 ACC/AHA PAD Guideline. The measures span the continuum of PAD management, from initial evaluation and diagnostic testing to preventive medical therapies, lifestyle modification, procedural considerations and attention to populations at greatest risk for disparities.

Notably, four performance measures and five quality measures are entirely new, reflecting emerging evidence, expanding therapeutic options and a growing emphasis on equity in vascular care. The four new performance measures focus specifically on medical therapy optimization, including blood pressure management, use of ACE inhibitors, diabetes management, and antithrombotic therapy, while the newly added quality measures address preventive foot care, lipid lowering using novel agents, evaluation of health disparities, saphenous vein assessment prior to revascularization, and multidisciplinary treatment for chronic limb‑threatening ischemia.

Among other highlights, a dedicated quality measure addresses disparities in PAD detection and management, underscoring the field's growing recognition that social drivers of health significantly influence outcomes. Shared decision-making is also elevated through a new quality measure emphasizing multidisciplinary discussions of risks and benefits. Additionally, the Writing Committee notes that for all but two measures if a clinician determines the care is inappropriate for the patient, that patient is excluded from the measure. For all measures, patients who decline treatment or care are excluded.

Looking ahead, the document also outlines priorities for future measure development, acknowledging ongoing questions about optimal duration and combinations of medical therapies, as well as the evolving role of novel agents for diabetes, obesity and recalcitrant hyperlipidemia. "Establishing high-quality evidence to guide the future integration of multiple medical therapies will undoubtedly be a subject of future quality measures," the document states. "The impact of health and social disparities on the care of individuals with PAD will also continue to influence future guidelines and measures."

The new performance measures were published in JACC and developed in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation, American Podiatric Medical Association, Association of Black Cardiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine, Society for Vascular Nursing, Society for Vascular Surgery, Society of Interventional Radiology, and the Vascular and Endovascular Surgery Society.