Evaluation of Medical Treatment for Peripheral Arterial Disease in Chinese High-Risk Patients

DOI Web Site 3 Citations 36 References
  • Hasimu Buaijiaer
    Heart, Lung and Blood Vessel Center, Tongji University School of Economics and Management, Tongji University Heart Center, The First Hospital, Xinjiang Medical University
  • Li Jue
    Heart, Lung and Blood Vessel Center, Tongji University
  • Yu Jinming
    Heart, Lung and Blood Vessel Center, Tongji University
  • Ma Yitong
    Heart Center, The First Hospital, Xinjiang Medical University
  • Zhao Mingzhong
    Heart, Lung and Blood Vessel Center, Tongji University
  • Nakayama Tomohiro
    Division of Molecular Diagnostics, Advanced Medical Research Center, Nihon University School of Medicine
  • Ma Wenlin
    Heart, Lung and Blood Vessel Center, Tongji University
  • Yang Jingang
    Heart Center, Beijing Tongren Hospital, Capital Medical University
  • Zheng Liqiang
    Heart, Lung and Blood Vessel Center, Tongji University
  • Li Xiankai
    Heart, Lung and Blood Vessel Center, Tongji University
  • Luo Yingyi
    Heart, Lung and Blood Vessel Center, Tongji University
  • Xu Yuanxi
    Heart, Lung and Blood Vessel Center, Tongji University
  • Zhang Lihua
    Heart, Lung and Blood Vessel Center, Tongji University
  • Zou Lilin
    Heart, Lung and Blood Vessel Center, Tongji University
  • Xiao Weilin
    Heart, Lung and Blood Vessel Center, Tongji University
  • Han Yalei
    Heart Center, Beijing Tongren Hospital, Capital Medical University
  • Hu Dayi
    Heart, Lung and Blood Vessel Center, Tongji University

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Abstract

Background Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis and is associated with elevated cardiovascular morbidity and mortality. The aim of the present study was to evaluate the use of antiplatelet agents, statins and angiotensin-converting enzyme inhibitors (ACEI) in Chinese high-risk cardiovascular (CV) patients with PAD, with an emphasis on the need for aggressive medical management of all atherosclerotic manifestations. Methods and Results Medical records from 5,263 Chinese patients at high risk of CV were evaluated for the use of antiplatelet agents, statins and ACEI in patients with and without PAD. PAD was defined as an ankle - brachial index (ABI) <0.9 in either leg. Multivariable logistic regression analyses were performed to compare medication use in the 2 groups. A total of 5,254 patients were analyzed (52.9% male, mean age 67.3 years). The prevalence of PAD in the total patient group was 25.4%; 22.5% of them had PAD only. Overall, 5.7% had PAD only, 19.6% had PAD and coronary heart disease (CHD) or stroke or diabetes, 7.7% had CHD only, 12.6% had stroke only, and 13.6% had diabetes only. The 28.9% subjects having none of PAD, CHD, stroke or diabetes were used as the reference group. Only 65%, 37% and 47% of all patients received antiplatelet agents, statins and ACEI, respectively. Antiplatelets, statins, ACEI and all 3 medications were used less frequently in PAD only patients (58.1%, 35.9, 53.5% and 21.6%) vs CHD only (90.9%, 74.5%, 70.6% and 55.9%, p<0.001). All 3 proven efficacious therapies were prescribed for only 56% of patients with CHD only, 8% with stroke only, 13% with diabetes only and 21% with PAD only. Conclusion PAD is prevalent in Chinese high-risk CV patients, equivalent to CHD, but these patients receive less intensive treatment than those with CHD. Programs to improve CV risk reduction in these high-risk patients are needed. (Circ J 2007; 71: 95 - 99)<br>

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