Abstract
Background - Peripheral vascular disease is a manifestation of systemic atherosclerosis and is associated with an increased risk of cardiovascular morbidity and mortality. Methods and Results - We examined clinical outcomes in 66 consecutive patients undergoing peripheral vascular interventions at our institution between January 2001 and October 2001. At hospital discharge and at 6 months, lifestyle modifications and use of evidence-based therapy was suboptimal. At 6 months, a significant proportion continued to smoke (22.7%) and only half of the patients exercised, controlled their weight, or modified their diet for lipid control. The use of antiplatelet therapy was 77.2%; of angiotensin-converting enzyme, 35.9%; of β-blockers, 42.5%; and of statins, 50%. Twelve of the 66 patients (18.2%) had a clinical event of death, myocardial infarction, or stroke. An appropriateness algorithm for use of secondary prevention measures was created with the use of evidence-based therapy guidelines, and a composite appropriateness variable was also created. The use of evidence-based therapy was associated with a significant reduction of the composite of death, myocardial infarction, and stroke at 6 months (OR 0.02, 95% CI 0.01 to 0.44, P=0.01). Conclusions - Atherosclerosis risk factors are very prevalent in patients with peripheral vascular disease, but these patients receive less than optimal treatment after a predominantly technical vascular intervention. Effective secondary prevention with appropriate lifestyle interventions and evidence-based medical therapy needs to be strongly encouraged and implemented in these patients.
| Original language | English |
|---|---|
| Pages (from-to) | 1909-1912 |
| Number of pages | 4 |
| Journal | Circulation |
| Volume | 106 |
| Issue number | 15 |
| DOIs | |
| State | Published - Oct 8 2002 |
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Keywords
- Atherosclerosis
- Hypertension
- Peripheral vascular disease
- Risk factors
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Missed opportunities to treat atherosclerosis in patients undergoing peripheral vascular interventions : Insights from the University of Michigan peripheral vascular disease quality improvement initiative (PVD-QI2). / Mukherjee, Debabrata; Lingam, Prasanth; Chetcuti, Stanley; Grossman, P. Michael; Moscucci, Mauro; Luciano, Ann E.; Eagle, Kim A.
In: Circulation, Vol. 106, No. 15, 08.10.2002, p. 1909-1912.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Missed opportunities to treat atherosclerosis in patients undergoing peripheral vascular interventions
T2 - Insights from the University of Michigan peripheral vascular disease quality improvement initiative (PVD-QI2)
AU - Mukherjee, Debabrata
AU - Lingam, Prasanth
AU - Chetcuti, Stanley
AU - Grossman, P. Michael
AU - Moscucci, Mauro
AU - Luciano, Ann E.
AU - Eagle, Kim A.
PY - 2002/10/8
Y1 - 2002/10/8
N2 - Background - Peripheral vascular disease is a manifestation of systemic atherosclerosis and is associated with an increased risk of cardiovascular morbidity and mortality. Methods and Results - We examined clinical outcomes in 66 consecutive patients undergoing peripheral vascular interventions at our institution between January 2001 and October 2001. At hospital discharge and at 6 months, lifestyle modifications and use of evidence-based therapy was suboptimal. At 6 months, a significant proportion continued to smoke (22.7%) and only half of the patients exercised, controlled their weight, or modified their diet for lipid control. The use of antiplatelet therapy was 77.2%; of angiotensin-converting enzyme, 35.9%; of β-blockers, 42.5%; and of statins, 50%. Twelve of the 66 patients (18.2%) had a clinical event of death, myocardial infarction, or stroke. An appropriateness algorithm for use of secondary prevention measures was created with the use of evidence-based therapy guidelines, and a composite appropriateness variable was also created. The use of evidence-based therapy was associated with a significant reduction of the composite of death, myocardial infarction, and stroke at 6 months (OR 0.02, 95% CI 0.01 to 0.44, P=0.01). Conclusions - Atherosclerosis risk factors are very prevalent in patients with peripheral vascular disease, but these patients receive less than optimal treatment after a predominantly technical vascular intervention. Effective secondary prevention with appropriate lifestyle interventions and evidence-based medical therapy needs to be strongly encouraged and implemented in these patients.
AB - Background - Peripheral vascular disease is a manifestation of systemic atherosclerosis and is associated with an increased risk of cardiovascular morbidity and mortality. Methods and Results - We examined clinical outcomes in 66 consecutive patients undergoing peripheral vascular interventions at our institution between January 2001 and October 2001. At hospital discharge and at 6 months, lifestyle modifications and use of evidence-based therapy was suboptimal. At 6 months, a significant proportion continued to smoke (22.7%) and only half of the patients exercised, controlled their weight, or modified their diet for lipid control. The use of antiplatelet therapy was 77.2%; of angiotensin-converting enzyme, 35.9%; of β-blockers, 42.5%; and of statins, 50%. Twelve of the 66 patients (18.2%) had a clinical event of death, myocardial infarction, or stroke. An appropriateness algorithm for use of secondary prevention measures was created with the use of evidence-based therapy guidelines, and a composite appropriateness variable was also created. The use of evidence-based therapy was associated with a significant reduction of the composite of death, myocardial infarction, and stroke at 6 months (OR 0.02, 95% CI 0.01 to 0.44, P=0.01). Conclusions - Atherosclerosis risk factors are very prevalent in patients with peripheral vascular disease, but these patients receive less than optimal treatment after a predominantly technical vascular intervention. Effective secondary prevention with appropriate lifestyle interventions and evidence-based medical therapy needs to be strongly encouraged and implemented in these patients.
KW - Atherosclerosis
KW - Hypertension
KW - Peripheral vascular disease
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=0037044417&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037044417&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.0000035649.39669.CE
DO - 10.1161/01.CIR.0000035649.39669.CE
M3 - Article
C2 - 12370211
AN - SCOPUS:0037044417
VL - 106
SP - 1909
EP - 1912
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 15
ER -