Abstract 4533: Adherence to ACC/AHA Guidelines for the Management of Patients with Peripheral versus Coronary Artery Disease in a Tertiary Care Center
Background: The ACC/AHA guidelines support aggressive risk factor management for pts with established coronary and other atherosclerotic vascular disease. Prior studies report that pts with peripheral artery disease (PAD) receive less aggressive medical therapy compared with pts with coronary artery disease (CAD). The goal of this study was to assess ACC/AHA guideline adherence among academic physicians in the management of PAD.
Methods: Between 1/2006 and 9/2007, 4477 pts admitted to our institution with the diagnoses of CAD and/or PVD were identified, and patterns of medication utilization were analyzed using current ACC/AHA recommendations. Pts were categorized into 3 groups: 1) PAD without known CAD (n=273); 2) CAD without PAD (n=3757); 3) PAD and CAD (n=447).
Results: Secondary prevention guidelines were less frequently utilized among PAD pts without known CAD, as compared to those diagnosed with CAD and no history of PAD. This trend was seen across all medications analyzed (Fig⇓.). Pts with concomitant PAD and CAD, however, were more likely than those only with CAD to be treated in accordance with current recommendations.
Conclusion: Despite well established guidelines for the treatment of PAD, pts with isolated PAD are frequently medically undertreated. Conversely, those patients with both PAD and CAD are managed most aggressively, closely approximating established guidelines.