Volume 15, Number 1, January-February 2008

Pharmacological secondary prevention in people with peripheral arterial disease compared to those with coronary artery disease: a missed opportunity
Simon EJ Janes, Joe West, Brian R Hopkinson, John T Walsh

People with peripheral arterial disease (PAD) have a high prevalence of modifiable risk factors for coronary artery disease (CAD). Whether these risk factors are adequately treated remains unknown. We investigated people admitted to hospital with PAD and CAD. We compared use of antiplatelet agents, statins and angiotensinconverting enzyme (ACE) inhibitors before and during admission. Multivariate analysis showed that before admission, compared to patients with CAD, patients with PAD had decreased use of antiplatelet agents (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.2–6.1), statins (OR 3.8, 95% CI 1.5–9.3) and ACE inhibitors (OR = 5.8, 95% CI 2.3–14.3). During admission, treatment was significantly less likely to be initiated in patients with PAD. This shows how secondary prevention can be neglected in patients with PAD. This is an important missed treatment opportunity, with substantial public health implications.

Br J Cardiol 2008;15:48-50.

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