Medical Therapy for Peripheral Artery Disease

• Criqui MH, Matsushita K, Aboyans V, Hess CN, Hicks CW, Kwan TW, et al. Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association. Circulation. 2021;144(9). The paper provides updates on the epidemiology and current knowledge in PAD.

•• Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;135(12). The paper is the latest AHA/ACC LEPAD guidelines.

•• Aboyans V, Ricco JB, Bartelink MLEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763–816. The paper is the latest ESC PAD guidelines.

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Hess CN, Huang Z, Patel MR, Baumgartner I, Berger JS, Blomster JI, et al. Acute Limb Ischemia in Peripheral Artery Disease. Circulation. 2019;140(7):556–65.

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King RW, Canonico ME, Bonaca MP, Hess CN. Management of Peripheral Arterial Disease: Lifestyle Modifications and Medical Therapies. J Soc Cardiovasc Angiogr Interv. 2022;1(6):100513.

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•• Bonaca MP, Nault P, Giugliano RP, Keech AC, Pineda AL, Kanevsky E, et al. Low-Density Lipoprotein Cholesterol Lowering With Evolocumab and Outcomes in Patients With Peripheral Artery Disease. Circulation. 2018;137(4):338–50. The paper is a subgroup analysis from FOURIER demonstrating the efficacy of evolocumab in PAD patients.

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• Narula N, Dannenberg AJ, Olin JW, Bhatt DL, Johnson KW, Nadkarni G, et al. Pathology of Peripheral Artery Disease in Patients With Critical Limb Ischemia. J Am Coll Cardiol. 2018;72(18):2152–63. The paper highlights the pathophysiology of ALI including the role of thrombo-embolism.

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Fakhry F, Spronk S, van der Laan L, Wever JJ, Teijink JAW, Hoffmann WH, et al. Endovascular Revascularization and Supervised Exercise for Peripheral Artery Disease and Intermittent Claudication. JAMA. 2015;314(18):1936.

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•• Aboyans V, Bauersachs R, Mazzolai L, Brodmann M, Palomares JFR, Debus S, et al. Antithrombotic therapies in aortic and peripheral arterial diseases in 2021: a consensus document from the ESC working group on aorta and peripheral vascular diseases, the ESC working group on thrombosis, and the ESC working group on cardiovascular pharmacotherapy. Eur Heart J. 2021;42(39):4013–24. The paper is the latest ESC consensus on antithrombotic therapy in PAD, including last evidence after LER.

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CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee Lancet. 1996;348(9038):1329–39.

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Canonico ME, Piccolo R, Avvedimento M, Leone A, Esposito S, Franzone A, et al. Antithrombotic Therapy in Peripheral Artery Disease: Current Evidence and Future Directions. J Cardiovasc Dev Dis. 2023;10(4):164.

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Cacoub PP, Bhatt DL, Steg PG, Topol EJ, Creager MA. Patients with peripheral arterial disease in the CHARISMA trial. Eur Heart J. 2008;30(2):192–201.

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Bonaca MP, Bhatt DL, Storey RF, Steg PhG, Cohen M, Kuder J, et al. Ticagrelor for Prevention of Ischemic Events After Myocardial Infarction in Patients With Peripheral Artery Disease. J Am Coll Cardiol. 2016;67(23):2719–28.

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Bonaca MP, Scirica BM, Creager MA, Olin J, Bounameaux H, Dellborg M, et al. Vorapaxar in Patients With Peripheral Artery Disease. Circulation. 2013;127(14):1522–9.

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Moll F, Baumgartner I, Jaff M, Nwachuku C, Tangelder M, Ansel G, et al. Edoxaban Plus Aspirin vs Dual Antiplatelet Therapy in Endovascular Treatment of Patients With Peripheral Artery Disease: Results of the ePAD Trial. J Endovasc Ther. 2018;25(2):158–68.

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•• Bonaca MP, Bauersachs RM, Anand SS, Debus ES, Nehler MR, Patel MR, et al. Rivaroxaban in Peripheral Artery Disease after Revascularization. N Engl J Med. 2020;382(21):1994–2004. The VOYAGER-PAD trial demonstrated the efficacy of DPI in symptomatic LEPAD patients undergoing LER.

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Hiatt WR, Bonaca MP, Patel MR, Nehler MR, Debus ES, Anand SS, et al. Rivaroxaban and Aspirin in Peripheral Artery Disease Lower Extremity Revascularization. Circulation. 2020;142(23):2219–30.

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Bauersachs RM, Szarek M, Brodmann M, Gudz I, Debus ES, Nehler MR, et al. Total Ischemic Event Reduction With Rivaroxaban After Peripheral Arterial Revascularization in the VOYAGER PAD Trial. J Am Coll Cardiol. 2021;78(4):317–26.

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Östergren J. Impact of ramipril in patients with evidence of clinical or subclinical peripheral arterial disease. Eur Heart J. 2004;25(1):17–24.

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Telmisartan R. or Both in Patients at High Risk for Vascular Events. N Engl J Med. 2008;358(15):1547–59.

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Bavry AA, Anderson RD, Gong Y, Denardo SJ, Cooper-DeHoff RM, Handberg EM, et al. Outcomes Among Hypertensive Patients With Concomitant Peripheral and Coronary Artery Disease. Hypertension. 2010;55(1):48–53.

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•• Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111–88. The paper is the latest ESC guidelines on dyslipidemia including LDL-C target in ASCVD patients.

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MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebocontrolled trial. Lancet. 2002;360(9326):7–22.

Randomized trial of the effects of cholesterol-lowering with simvastatin on peripheral vascular and other major vascular outcomes in 20,536 people with peripheral arterial disease and other high-risk conditions. J Vasc Surg. 2007;45(4):645–654.e1.

Kumbhani DJ, Steg PhG, Cannon CP, Eagle KA, Smith SC, Goto S, et al. Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry. Eur Heart J. 2014;35(41):2864–72.

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Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med. 2015;372(25):2387–97.

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Bonaca MP, Gutierrez JA, Cannon C, Giugliano R, Blazing M, Park JG, et al. Polyvascular disease, type 2 diabetes, and long-term vascular risk: a secondary analysis of the IMPROVE-IT trial. Lancet Diabetes Endocrinol. 2018;6(12):934–43.

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Lloyd-Jones DM, Morris PB, Ballantyne CM, Birtcher KK, Covington AM, DePalma SM, et al. 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk. J Am Coll Cardiol. 2022;80(14):1366–418.

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•• Jukema JW, Szarek M, Zijlstra LE, de Silva HA, Bhatt DL, Bittner VA, et al. Alirocumab in Patients With Polyvascular Disease and Recent Acute Coronary Syndrome. J Am Coll Cardiol. 2019;74(9):1167–76. The paper is a subgroup analysis from ODYSSEY OUTCOMES demonstrating the efficacy of alirocumab in PAD patients.

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Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, et al. Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. N Engl J Med. 2018;379(22):2097–107.

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Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019;380(1):11–22.

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