Abstract 290: Comparison of Lipid Control in Patients with Coronary versus Peripheral Arterial Disease

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Objectives: Patients with Peripheral artery disease (PAD) have similar cardiovascular morbidity and mortality as those with established coronary artery disease (CAD). Thus the recommended LDL goal is < 100 mg/dl for both CAD and PAD patients. This study assesses the degree of lipid control and statin drug use in CAD and PAD patients in current clinical practice. Methods: We did a retrospective chart review of patients with a diagnosis of PAD, CAD and both PAD and CAD seen at our institution between Jan 2009 to March 2012. Demographic data, lipid levels and statin use were compared between CAD, PAD and PAD & CAD groups. To enable comparison of the doses of various statins, we used statin potency unit where 1 potency unit = 10mg of Simvastatin. Results: There were a total of 11498 subjects in the chart review (CAD-9879, PAD-623, both PAD & CAD -996). PAD patients were younger with more females & lower BMI compared to CAD and both PAD & CAD groups (Table 1). Mean LDL level in the PAD group was 93.4±35.5 mg/dL, CAD group was 82.7±33.1 mg/dL and both PAD & CAD group was 80.5±31.0 mg/dL. Although all groups had a mean LDL of < 100mg/dL, significantly fewer number of PAD patients achieved target LDL <100 mg/dl and LDL <70 mg/dl, as compared to CAD and combined group (Table 1). The PAD group had significantly higher mean total cholesterol and mean LDL levels as compared to the CAD group and combined PAD & CAD group (Table 1). The mean HDL and mean triglyceride (TG) levels in PAD group were significantly higher than the CAD and combined PAD & CAD group. The PAD patients had significantly greater use of less potent statins than the CAD and PAD & CAD groups which was not compensated for by a higher mean dose of the lower potency statins (Table 1). PAD patients were receiving significantly lower mean potency unit of statins as compared to PAD and combined CAD and PAD group (Table 1). Conclusion: Even though both PAD and CAD groups had mean LDL < 100mg/dL, we found that lipid control assessed by absolute mean lipid levels were significantly better in patients with CAD and combined PAD & CAD group. Thus, our study indicates that physicians tend to be more aggressive with lipid control in patients with a diagnosis of CAD when compared to patients with PAD alone.