title: A prospective multicentre study on the treatment of cardiovascular risk factors and claudication symptoms in patients with peripheral artery disease (the IDOMENEO study).
abstract: BACKGROUND
  The objective of this prospective multicenter cohort study was to characterise the use of pharmacological and non-pharmacological treatment for cardiovascular disease (CVD) risk factors and intermittent claudication (IC) symptoms in clinical practice patients with peripheral artery disease (PAD), and to determine the care gap with international guidelines and evidence-based therapy.
  
  
  METHODS
  From 2011 through 2013, participating centres enrolled consecutive patients with PAD of atherosclerotic, origin demonstrated by ultrasound, ankle brachial index (ABI) < 0.9 and symptoms of IC. A seven item grid was built for the assessment of care gap (percentage of patients eligible for a treatment who did not receive it). cerebrovascular disease or at least two CVD risk factors. Care gap was lower than 25 % for any method to stop smoking, lipid lowering agents, antiplatelet and/or anticoagulation therapy and any kind of exercise program; between 25% and 50% for ACE inhibitors/ angiotensin II antagonist therapy; between 50% and 75% for beta-blocker therapy; and higher than 75% for supervised exercise program and use of cilostazol. Patients with and without CADI cerebrovascular disease were differently treated with clopidogrel (27.3% and 4.8 %, p < 0.001), any antiplatelet/anticoagulant therapy (98.7% and 83.3 %, p <0.001) and beta-blockers (46.8% and 16.0%, p<0.001).
  
  
  RESULTS
  All patients (232) presented at least one CVC risk factor, 90.2% at least two, and 91.5% had either established CAD or
  
  
  CONCLUSIONS
  Many gaps with evidence-based recommendations are still present in the pattern of the use of pharmacological and non-pharmacological treatment for CVD risk factors and IC symptoms in clinical practice PAD patients.
authors: 1 Internal Medicine, Vimercate Hospital, Italy.
authors: Claudio
authors: C
authors: Cimminiello
authors: Guido
authors: G
authors: Arpaia
authors: Hernan
authors: H
authors: Polo Friz
authors: Patrizia
authors: P
authors: Boracchi
authors: Giuseppe
authors: G
authors: Marano
authors: Gabriella
authors: G
authors: Spezzigu
authors: Adriana
authors: A
authors: Visonà
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D000792:Angiography; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D055109:Ankle Brachial Index / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005081:Exercise Therapy / Q000379:methods; D005500:Follow-Up Studies; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D015994:Incidence; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007558:Italy; D010349:Patient Compliance; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D000960:Hypolipidemic Agents
keywords: Abdominal aortic aneurysm; intraluminal thrombus; pulse wave analysis; pulse wave velocity