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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

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ACE up the sleeve - are vascular patients medically optimized?

A P Coveney¹, G C O'Brien, G J Fulton

¹Department of Vascular Surgery, Cork University Hospital, National University of Ireland, Cork, Ireland. acoveney@gmail.com

Vascular Health and Risk Management

|February 23, 2011

Summary

Arteriopathic patients often receive antiplatelets and statins, but angiotensin-converting enzyme (ACE) inhibitors and beta-blockers are under-prescribed. Vascular surgeons can improve medical management by enhancing collaboration and taking greater responsibility for patient care.

Keywords:

ACE inhibitors arteriopathic disease beta-blockers statins vascular disease

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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

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Published on: June 12, 2021

Area of Science:

Vascular Surgery
Cardiovascular Medicine
Pharmacology

Background:

Arteriopathic patients require comprehensive medical management.
Optimal medical therapy is crucial for improving outcomes in patients with arterial disease.
Patients with vascular conditions are often managed by multiple medical specialties.

Purpose of the Study:

To assess the current medical management of arteriopathic patients in a vascular surgical service.
To evaluate the prescription rates of key cardiovascular medications, including antiplatelets, statins, ACE inhibitors, ARBs, and beta-blockers.
To determine the influence of different medical specialties on medication prescribing patterns.

Main Methods:

A 6-month prospective study of sequential patients attending a university teaching hospital's vascular surgical service.
Data collection included patient demographics, arterial disease type, recent medical consultations, and current medications.
Specific focus on the use of antiplatelets, statins, ACE inhibitors (or ARBs), and beta-blockers.

Main Results:

180 arteriopathic patients (mean age 69) were included.
Nearly all patients (96%) received antiplatelets, predominantly aspirin.
High statin use (86%), but lower rates for beta-blockers (44%) and ACE inhibitors (51%).
Suboptimal prescription of ACE inhibitors and beta-blockers was observed irrespective of specialty consultations.

Conclusions:

While antiplatelet and statin use aligns with evidence, ACE inhibitors and beta-blockers are under-prescribed in this population.
Vascular surgeons have an opportunity to improve medical care by adhering to guidelines.
Enhanced collaboration with primary care or increased surgeon responsibility for medical management is recommended.