Evidence-based recommendations for medical management of Peripheral Artery Disease

Golledge, Jonathan, and Drovandi, Aaron (2021) Evidence-based recommendations for medical management of Peripheral Artery Disease. Journal of Atherosclerosis and Thrombosis, 28 (6). pp. 573-583.

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Abstract

Patients with lower limb artery stenosis or occlusion (peripheral artery disease; PAD) have been determined to be at very high risk of both major adverse cardiovascular events, such as myocardial infarction and stroke, and major adverse limb events, such as amputation and requirement for artery surgery.

Effective medical management has been identified as key in reducing this risk; however, this is often poorly implemented in clinical practice. Thus, the aim of this narrative review was to summarize the current evidence on the medical management of PAD in order to inform clinicians and highlight recommendations for clinical practice. International guidelines, randomized controlled trials, and relevant systematic reviews and metaanalyses have been included in this study. The focus was the management of the key modifiable risk factors to mitigate possible adverse events through prescription of anti-platelet and anticoagulation drugs and medications to control low-density lipoprotein cholesterol, blood pressure, and diabetes and aid smoking cessation. The available evidence from randomized clinical trials provide a strong rationale for the need for holistic medical management programs that are effective in achieving uptake of these medical therapies in patients with PAD. In conclusion, people with PAD have some of the highest adverse event rates among those with cardiovascular diseases. Secondary preventive measures have been proven effective in reducing these adverse events; however, they remain to be adequately implemented. Thus, the need for an effective implementation program has emerged to reduce adverse events in this patient group.

Item ID: 69592
Item Type: Article (Research - C1)
ISSN: 1880-3873
Keywords: Secondary prevention, Modifiable risk factors, Medical management
Copyright Information: Copyright © 2021 Japan Atherosclerosis SocietyThis article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC 1063476, NHMRC 1022752
Date Deposited: 12 Oct 2021 01:01
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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