Guideline-directed statin therapy in patients with new or worsening symptoms of peripheral artery disease

Resource Information

The work Guideline-directed statin therapy in patients with new or worsening symptoms of peripheral artery disease represents a distinct intellectual or artistic creation found in Missouri University of Science & Technology Library. This resource is a combination of several types including: Work, Language Material, Books.

Label

Guideline-directed statin therapy in patients with new or worsening symptoms of peripheral artery disease

Statement of responsibility

by Yevgeniy Khariton

Creator

• Khariton, Yevgeniy, 1989-

Contributor

• Smolderen, Kim G.

Author

• Khariton, Yevgeniy, 1989-

Degree supervisor

• Smolderen, Kim G.

Subject

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Peripheral Arterial Disease
• Peripheral vascular diseases
• Statins (Cardiovascular agents)
• Thesis -- University of Missouri--Kansas City -- Medicine
• Electronic dissertations
• Electronic dissertations

Genre

• Electronic dissertations

Language

eng

Summary

Objective: The ACC/AHA cholesterol guidelines recommend patients with peripheral artery disease (PAD) be treated with a moderate to high-intensity statin. The extent to which PAD patients with new or worsening claudication symptoms are offered guideline statin therapy is unknown. Methods: In the PORTRAIT registry, patterns of statin therapy were assessed in 1144 patients at 16 PAD specialty clinics (between June 2011-December 2015) before and after an evaluation for new or worsening claudication symptoms. It was documented whether patients had been previously treated with a guideline-directed statin as well as switched from non guideline to guideline statin therapy. Patient factors predicting intensification to guideline statin were examined. Site and provider-level variation in guideline statin intensification were summarized by calculating median odds ratios. Results: Among 1144 patients, 810 (70.8%) were initially on guideline therapy compared with 334 (29.2%) that were not. In the latter, 103 (30.8%) were prescribed guideline therapy after evaluation. Patients with typical symptoms displayed greater odds of intensification to guideline statin (OR 3.75; 95% CI: 1.22-11.53) while older patients had lower odds (OR 0.60/decade; 95% CI: 0.40-0.87). Variability in guideline statin intensification was observed across sites (Adjusted Median Odds Ratio = 3.63; 95% CI 1.88-5.42, (p <0.05)) but not providers (Adjusted Median Odds Ratio = 1.90; 95% CI 1.00-2.55, (p >0.05)). Conclusions: In conclusion, most patients evaluated at a PAD specialty clinic for new or worsening claudication symptoms arrived on a guideline-directed statin. Only 31% originally off guideline therapy were intensified to a guideline statin. These findings highlight an important opportunity to optimize medical therapy for patients with PAD

Cataloging source

UMK

Degree

M.S.

Dissertation note

(School of Medicine).

Dissertation year

2018.

Granting institution

University of Missouri-Kansas City,

Illustrations

illustrations

Index

no index present

Literary form

non fiction

Nature of contents

• dictionaries
• bibliography
• theses