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@article{Saratzis:2019:10.1002/bjs.11214,
author = {Saratzis, A and Jaspers, NEM and Gwilym, B and Thomas, O and Tsui, A and Lefroy, R and Parks, M and Htun, V and Mera, Z and Thatcher, A and Bosanquet, D and Forsythe, R and Benson, R and Dattani, N and Dovell, G and Lane, T and Shalhoub, J and Sidloff, D and Visseren, FLJ and Dorresteijn, JAN and Richards, T and Saratzis, A and Jaspers, N and Gwilym, B and Thomas, O and Tsui, A and Lefroy, R and Parks, M and Htun, V and Mera, Z and Thatcher, A and Bosanquet, D and Forsythe, R and Benson, R and Dattani, N and Dovell, G and Lane, T and Shalhoub, J and Sidloff, D and Visseren, F and Dorresteijn, J and Richards, T},
doi = {10.1002/bjs.11214},
journal = {British Journal of Surgery},
pages = {1168--1177},
title = {Observational study of the medical management of patients with peripheral artery disease},
url = {http://dx.doi.org/10.1002/bjs.11214},
volume = {106},
year = {2019}
}

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TY  - JOUR
AB  - BackgroundPrevious research has suggested that patients with peripheral artery disease (PAD) are not offered adequate risk factor modification, despite their high cardiovascular risk. The aim of this study was to assess the cardiovascular profiles of patients with PAD and quantify the survival benefits of targetbased risk factor modification.MethodsThe Vascular and Endovascular Research Network (VERN) prospectively collected cardiovascular profiles of patients with PAD from ten UK vascular centres (April to June 2018) to assess practice against UK and European goaldirected best medical therapy guidelines. Risk and benefits of risk factor control were estimated using the SMARTREACH model, a validated cardiovascular prediction tool for patients with PAD.ResultsSome 440 patients (mean(s.d.) age 70(11) years, 24·8 per cent women) were included in the study. Mean(s.d.) cholesterol (4·3(1·2) mmol/l) and LDLcholesterol (2·7(1·1) mmol/l) levels were above recommended targets; 319 patients (72·5 per cent) were hypertensive and 343 (78·0 per cent) were active smokers. Only 11·1 per cent of patients were prescribed highdose statin therapy and 39·1 per cent an antithrombotic agent. The median calculated risk of a major cardiovascular event over 10 years was 53 (i.q.r. 44–62) per cent. Controlling all modifiable cardiovascular risk factors based on UK and European guidance targets (LDLcholesterol less than 2 mmol/l, systolic BP under 140 mmHg, smoking cessation, antiplatelet therapy) would lead to an absolute risk reduction of the median 10year cardiovascular risk by 29 (20–38) per cent with 6·3 (4·0–9·3) cardiovascular diseasefree years gained.ConclusionThe medical management of patients with PAD in this secondary care cohort was suboptimal. Controlling modifiable risk factors to guidelinebased targets would confer significant patient benefit.
AU  - Saratzis,A
AU  - Jaspers,NEM
AU  - Gwilym,B
AU  - Thomas,O
AU  - Tsui,A
AU  - Lefroy,R
AU  - Parks,M
AU  - Htun,V
AU  - Mera,Z
AU  - Thatcher,A
AU  - Bosanquet,D
AU  - Forsythe,R
AU  - Benson,R
AU  - Dattani,N
AU  - Dovell,G
AU  - Lane,T
AU  - Shalhoub,J
AU  - Sidloff,D
AU  - Visseren,FLJ
AU  - Dorresteijn,JAN
AU  - Richards,T
AU  - Saratzis,A
AU  - Jaspers,N
AU  - Gwilym,B
AU  - Thomas,O
AU  - Tsui,A
AU  - Lefroy,R
AU  - Parks,M
AU  - Htun,V
AU  - Mera,Z
AU  - Thatcher,A
AU  - Bosanquet,D
AU  - Forsythe,R
AU  - Benson,R
AU  - Dattani,N
AU  - Dovell,G
AU  - Lane,T
AU  - Shalhoub,J
AU  - Sidloff,D
AU  - Visseren,F
AU  - Dorresteijn,J
AU  - Richards,T
DO  - 10.1002/bjs.11214
EP  - 1177
PY  - 2019///
SN  - 0007-1323
SP  - 1168
TI  - Observational study of the medical management of patients with peripheral artery disease
T2  - British Journal of Surgery
UR  - http://dx.doi.org/10.1002/bjs.11214
UR  - http://hdl.handle.net/10044/1/71415
VL  - 106
ER  -

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