Sucharitkul, PPJ, Jones, KL, Scott, DJA orcid.org/0000-0003-2894-9923 et al. (1 more author) (2021) Lipid optimisation in lower extremity peripheral arterial disease. Annals of Vascular Surgery, 76. pp. 542-554. ISSN 0890-5096
Abstract
Aims
This review aims to explore the current guidance and issues surrounding lipid optimisation of patients with peripheral arterial disease (PAD).
Methods
A narrative review of the global PAD guidance, specifically focusing on low density lipoprotein cholesterol (LDL-C) reduction methods including; ‘treating to target’, ‘fire and forget’ and LDL-C percentage reduction. Advanced literature searches were carried out in Pubmed and Google Scholar databases comparing most recent PAD lipid guidance.
Results
PAD lipid guidance could be improved internationally to help clinicians implement the best lipid-reduction strategies for their patients and challenge the arbitrary 1.4mmol/L LDL-C target in line with novel proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK-9i) trials. By educating primary and secondary care staff on the benefits of maximal lipid-reduction therapies, we can reduce major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Championing PAD community clinics may lead to earlier prevention. Research comparing lipid-reduction strategies in practice is needed to improve outcomes internationally, and ongoing practice audited to understand the extent of under-prescribing in PAD.
Conclusions
This review highlights the current PAD lipid-reduction treatments and the clarity issues of global guidance. Further research is needed to tackle ongoing mortality and morbidity rates in PAD patients against their better off cardiovascular disease (CVD) peers.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2021 Elsevier Inc. All rights reserved. This is an author produced version of an article published in Annals of Vascular Surgery. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | “Cholesterol”, “Hydroxymethylglutaryl-CoA Reductase Inhibitors”, “Ezetimibe”, “Evolocumab”, “Alirocumab”, “Peripheral Arterial Disease”, “Vascular Disease”, “Atherosclerosis”, “Secondary Prevention”, “Lipoprotein, LDL” |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Discovery & Translational Science Dept (Leeds) |
Funding Information: | Funder Grant number British Heart Foundation FS/18/12/33270 |
Depositing User: | Symplectic Publications |
Date Deposited: | 19 May 2021 13:18 |
Last Modified: | 28 Jun 2022 11:22 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.avsg.2021.03.055 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:174260 |
Download
Filename: Sucharitkul et al 2021 Annals of Vascular Surgery AAM.pdf
Licence: CC-BY-NC-ND 4.0