title: Lower extremities peripheral arterial disease among patients admitted to cardiac rehabilitation: the THINKPAD registry.
abstract: OBJECTIVE
  Lower extremities peripheral arterial disease (LE-PAD) across the wide range of conditions for Cardiac Rehabilitation (CR) is poorly understood. The "ATHerosclerosis of the lower extremIties as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation" (THINKPAD) registry explored LE-PAD in CR patients in terms of prevalence and interventions delivered.
  
  
  METHODS
  Multicenter, consecutive case series of 1506 patients discharged from 16 CR Units in Italy from May 1 to June 30, 2012.
  
  
  RESULTS
  LE-PAD constituted a primary indication for CR and a comorbidity on admission in 2.6% and 9.3% of patients respectively. LE-PAD patients were significantly older (72 ± 9 vs. 67 ± 12 years, p<0.001) and displayed a worse cardiovascular risk profile (diabetes 38% vs. 23%, hypertension 86% vs. 63%, hypercholesterolemia 74% vs. 52%, smoking 72% vs. 50%, low level of physical activity 84% vs. 69%, impaired diet habits 69% vs. 55%, p<0.01 for all). COPD (17% vs. 11%, p<0.05), CKD (20% vs. 10%, p<0.01), and past history of coronary revascularization (29% vs. 14%, p<0.001) were also more represented in the LE-PAD group. Half of LE-PAD patients received a formal staging, with low provision of ABI (18%) and color Doppler (48%) investigation. Secondary prevention targets at the end of CR for blood pressure and lipid control were accomplished in 83% and 46% of patients respectively (strongly correlated with the presence of CAD), while other guideline-recommended drugs for LE-PAD were prescribed in less than 4% of cases.
  
  
  CONCLUSIONS
  LE-PAD represents an uncommon referral indication for CR. Our data confirm its systematic underassessment and undertreatment.
authors.affiliation: Cardiovascular Rehabilitation Unit, Le Terrazze Clinic, Cunardo, VA, Italy. Electronic address: m.ambrosetti@clinicaleterrazze.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Ambrosetti
authors.affiliation: Salvatore Maugeri Foundation, IRCCS - Scientific Institute of Veruno-Cardiac Rehabilitation Division, Veruno, NO, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Temporelli
authors.affiliation: Division of Cardiology, Spedali Civili, University of Brescia, Brescia, Italy.
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
authors.affiliation: Salvatore Maugeri Foundation, IRCCS-Scientific Institute of Montescano-Cardiac Rehabilitation Division, Montescano, PV, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Febo
authors.affiliation: Cardiac Rehabilitation Unit, Rivolta d'Adda Hospital, Rivolta d'Adda, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Diaco
authors.affiliation: Cardiac Rehabilitation Unit, Motta di Livenza Hospital, Motta di Livenza, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Favretto
authors.affiliation: ASL 3 Genovese, La Colletta Hospital, Cardiac Rehabilitation Unit, Arenzano, Italy.
authors.forename: Pasqualina
authors.initials: P
authors.lastname: Calisi
authors.affiliation: Division of Cardiology, Castelvetrano Hospital, Castelvetrano, TP, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gabriele
authors.affiliation: San Giovanni-Addolorata Hospital Complex, Division of Cardiology III, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Greco
authors.affiliation: GVM Hospitals of Care and Research, Ettore Sansavini Health Science Foundation, Cotignola, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology* / Q000534:rehabilitation*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Cardiac rehabilitation; Epidemiology; Peripheral arterial disease; Secondary prevention