LDL Cholesterol Targets in Patients Undergoing Peripheral Revascularization

pp. 205-209

Abstract

Background: Patients with peripheral vascular disease represent a group at high risk of cardiovascular events, and must therefore achieve the secondary prevention goals recommended in the guidelines.

Objectives: Primary: To determine what percentage of patients undergoing peripheral revascularization surgery reached LDL cholesterol goals at 6 months of the intervention compared with patients undergoing coronary artery bypass grafting. Secondary: To determine the percentage of patients reaching these levels at 18 months of follow-up, the percentage of patients  with total cholesterol dosage and lipid fraction (LDL-C, HDL-C and TG) assessment at 6 and 18 months of follow-up and the
percentage of statin use during the previous year and during the long term follow-up after surgery.

Methods: The degree of lipid control in a retrospective cohort of patients undergoing peripheral revascularization surgery was compared with another group of patients undergoing coronary artery bypass grafting at 6 months and 18 months of the procedure.

Results: A total of 468 individuals, 98 undergoing surgery for peripheral vascular disease and 370 for coronary artery disease were followed up for a period of 18 months. Mean LDL-C at 6 months of surgery was significantly higher in the vascular than in the coronary patients (98.8±35 mg/dl vs. 84.7±25 mg/dl, p=0.001), but lost significance at 18 months (93.3±23 mg/dl vs. 88±26 mg/dl, p=0.25). The percentage of patients achieving LDL-C target <100 mg/dl was 27.5% vs. 48.6% (p <0.0001) at 6 months in the vascular and coronary patients, respectively, and 22.5% vs. 37.3% (p=0.006) at 18 months.

Conclusion: A lower percentage of patients undergoing surgical procedures for peripheral revascularization achieve LDL-C targets compared with those undergoing coronary revascularization.