Adherence to lipid management guidelines is associated with lower mortality and major adverse limb events in patients undergoing revascularization for chronic limb-threatening ischemia

Journal of Vascular Surgery
Thomas F X O'DonnellMarc L Schermerhorn

Abstract

The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations. We identified all patients with CLTI who underwent first-time revascularization (endovascular or surgical) at Beth Israel Deaconess Medical Center from 2005 to 2014. Patients were classified as taking high-intensity, moderate-intensity, low-intensity, or no statin postoperatively. Outcomes included death and major adverse limb event (MALE). Propensity scores were calculated for the probability of receiving guideline-recommended intensity of statin therapy to account for nonrandom assignment of treatments. Cox regression models were constructed and adjusted for the propensity scores and further adjusted for strong potential confounders. After excluding patients on hemodialysis (n = 252), we identified 1019 limbs from 931 patients with ...Continue Reading

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Citations

Dec 19, 2019·Current Treatment Options in Cardiovascular Medicine·Alicia ChionchioBenjamin Hirsh
Dec 31, 2019·European Heart Journal. Cardiovascular Pharmacotherapy·Jörn F DopheideHeinz Drexel
Jun 4, 2020·Scandinavian Journal of Clinical and Laboratory Investigation·Niina KhanNiku Oksala
Aug 6, 2020·Journal of the American Heart Association·Simin HuaRobert C Kaplan
Mar 7, 2021·International Journal of Molecular Sciences·Federico BiscettiAndrea Flex
Jun 9, 2021·Annals of the Academy of Medicine, Singapore·Sze Ling ChanTjun Yip Tang
Jun 29, 2021·Journal of Vascular Surgery·Benjamin G AllarMarc L Schermerhorn
Aug 15, 2021·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Samick SofatPatrick A Coughlin

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