Abstract 13576: Use of Cardioprotective Medications Remain Underused in Patients with Peripheral Arterial Disease
Background: Patients with peripheral arterial disease (PAD) are at high risk for vascular events, leading to the classification of PAD as a coronary artery disease (CAD) equivalent. Yet, contemporary use of cardioprotective medications in patients with PAD remains poorly described.
Methods: Using nationwide administrative registries in Denmark we sought to compare the use of cardioprotective medications (aspirin, clopidogrel, statins, and ACE-inhibitors) among patients with incident PAD and no history of CAD, PAD with a history of CAD, and CAD alone. We excluded patients treated with warfarin and percentage of medication use was calculated conditional on patients surviving through the time-period of interest.
Results: Overall, 34,160 patients with PAD alone were included; 9,570 with PAD and history of CAD; and 155,173 with CAD alone. Median age (IQR) and % male sex according to group were: 71.0 yr (62.3-78.8) and 52.1% men; 73.6 yr (66.0-80.3) and 62.1% men; and 72.8 yr (62.5-81.4) and 59.6%, respectively. Use of EBM's increased only modestly after diagnosis of PAD. Patients with incident diagnosis PAD and no history of CAD were less likely to be prescribed cardioprotective medications compared with patients with CAD, while patients with history of CAD and subsequent new diagnosis of PAD tended to be treated as aggressively as patients with CAD (Table).
Conclusion: Use of cardioprotective medications remains underused among patients with PAD compared to patients with CAD. Given these patients are at high risk for vascular events, increased attention is needed to optimize secondary prevention strategies in this high-risk population.
- © 2011 by American Heart Association, Inc.