title: Comparison of lipid management in patients with coronary versus peripheral arterial disease.
abstract: Peripheral arterial disease (PAD), similar to coronary artery disease (CAD), is a significant predictor of cardiovascular morbidity and mortality. Guidelines recommend a low-density lipoprotein (LDL) goal of <100 mg/dl for both groups. We assessed whether lipid control and statin use were as aggressively applied to PAD as to patients with CAD. This retrospective study of patients with the diagnosis of CAD, PAD, or both CAD and PAD compared lipid levels and statin use. For comparison of statins, we used a statin potency unit (1 potency unit=10 mg of simvastatin). Among 11,134 subjects (CAD 9,563, PAD 596, and both CAD and PAD 975), mean LDL in the PAD group was higher than the CAD (92 vs 83 mg/dl, respectively, p<0.001) and the combined CAD and PAD groups (92 vs 80 mg/dl, respectively, p<0.001). Fewer patients with PAD achieved a target LDL of <100 mg/dl compared with CAD (62% vs 78%, respectively, p<0.001) and the combined group (62% vs 79%, respectively, p<0.001). Similar differences were noted for a target LDL of <70 mg/dl. Compared with the CAD group, a lesser number of patients with PAD received statin therapy (76% vs 100%, respectively, p<0.001) with lower mean potency unit (5.3 vs 8.1, respectively, p<0.001). In conclusion, our study demonstrated lower use and less aggressive application of statins in patients with PAD compared with patients with CAD, ensuing lower mean LDL in the CAD and combined PAD and CAD groups. Our study suggests that physicians are more aggressive with lipid control in patients with CAD compared with patients with PAD alone.
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Suresh
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Thapa
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Vinodh
authors.initials: V
authors.lastname: Jeevanantham
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Taylor
authors.initials: T
authors.lastname: Myers
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Casper
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Biostatistics, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Michael
authors.initials: M
authors.lastname: Brimacombe
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: James L
authors.initials: JL
authors.lastname: Vacek
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas.
authors.forename: Buddhadeb
authors.initials: B
authors.lastname: Dawn
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular Diseases, University of Kansas Medical Center and Hospital, Kansas City, Kansas. Electronic address: kgupta@kumc.edu.
authors.forename: Kamal
authors.initials: K
authors.lastname: Gupta
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007615:Kansas / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008297:Male; D009017:Morbidity / Q000639:trends; D058729:Peripheral Arterial Disease / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids