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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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A retrospective analysis on optimal medical therapy for patients with symptomatic lower extremity peripheral artery

Camille de Kermenguy1,2, Anne Durand1,2, Quentin Tollenaere1,2

  • 1Vascular Medicine Unit, CHU Rennes, 2 Rue Henri Le Guilloux, Rennes, 35033, France.

BMC Cardiovascular Disorders
|November 1, 2024
PubMed

Insights

Most lower extremity artery disease (LEAD) patients do not achieve LDL-cholesterol (LDLc) goals, with suboptimal medical treatment prevalence. Patients with a history of vascular surgery showed no improved management despite consistent follow-up.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Pharmacology

Background:

  • Symptomatic lower extremity artery disease (LEAD) management requires optimal lipid control (LDL-cholesterol [LDLc]) and medical therapy.
  • The prevalence of LEAD patients achieving LDLc < 0.55 g/L and optimal medical treatment is not well-established.
  • Optimal medical treatment includes triple therapy: antiplatelet, statin, and ACE inhibitor/ARB.

Purpose of the Study:

  • To determine the prevalence of LEAD patients achieving LDLc < 0.55 g/L.
  • To assess the prevalence of optimal medical treatment in LEAD patients.
  • To compare management strategies between LEAD patients with and without a history of vascular surgery.
  • To evaluate eligibility for novel lipid-lowering therapies (FOURIER and REDUCE-IT criteria).

Main Methods:

  • Single-center retrospective study design.
  • Prevalence calculated using numbers and percentages.
  • Comparison of management between LEAD patients with and without prior vascular surgery.
  • Calculation of patient eligibility for FOURIER (evolocumab) and REDUCE-IT (icosapent ethyl) studies.

Main Results:

  • Only 12.4% of LEAD patients achieved LDLc < 0.55 g/L.
  • Optimal medical treatment was received by 50.7% of patients.
  • No significant difference in LDLc goal achievement between patients with (10.6%) and without (13.6%) vascular surgery history.
  • 46.0% of patients were eligible for evolocumab and 8.4% for icosapent ethyl.

Conclusions:

  • A significant majority of lower extremity artery disease patients do not meet LDL-cholesterol goals.
  • LEAD patients with a history of vascular surgery did not demonstrate superior management outcomes.
  • Despite more consistent follow-up, vascular surgery history did not correlate with better medical management in LEAD patients.
Abstract

Keywords:
Lipid objectivesPeripheral artery diseaseTreatmentTriglycerides

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