The use of evidence-based medical therapy in patients with critical limb-threatening ischaemia
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
The use of evidence-based medical therapy in patients with critical limb-threatening ischaemia. / Bager, Lucas Grove Vejlstrup; Petersen, Jeppe Kofoed; Havers-Borgersen, Eva; Resch, Timothy; Smolderen, Kim G.; Mena-Hurtado, Carlos; Eiberg, Jonas; Køber, Lars; Fosbøl, Emil Loldrup.
I: European Journal of Preventive Cardiology, Bind 30, Nr. 11, 2023, s. 1092-1100.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - The use of evidence-based medical therapy in patients with critical limb-threatening ischaemia
AU - Bager, Lucas Grove Vejlstrup
AU - Petersen, Jeppe Kofoed
AU - Havers-Borgersen, Eva
AU - Resch, Timothy
AU - Smolderen, Kim G.
AU - Mena-Hurtado, Carlos
AU - Eiberg, Jonas
AU - Køber, Lars
AU - Fosbøl, Emil Loldrup
N1 - Publisher Copyright: © The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Aims: To describe the practice patterns of evidence-based medical therapy (EBM) and overall mortality in high-risk patients with critical limb-threatening ischaemia (CLTI), compared with patients with myocardial infarction (MI). Methods and results: Using Danish registries, we identified patients 40-100 years of age with a first-time hospitalization for CLTI or MI from 2008-2018 and grouped them into CLTI, MI, and CLTI and history of MI (CLTI + MI). We examined the likelihood of filling prescriptions with EBM [i.e. antiplatelets (Aps), lipid-lowering agents (LLAs), angiotensin-converting enzyme inhibitor (ACEi), or angiotensin II-receptor blockers (ARBs)] within 3 months after discharge among survivors. Further, we assessed the adjusted 3-year mortality rates. We included 92 845 patients: 14 941 with CLTI (54.7% male), 74 830 with MI (64.6% male) and 3,074 with CLTI + MI (65.2% male). Patients with CLTI and CLTI + MI were older and had more comorbidities than patients with MI. Compared with patients with MI, the unadjusted odds ratios of filling prescriptions were 0.15 [confidence interval (CI): 0.14-0.15] for AP, 0.26 (CI: 0.25-0.27) for LLA, and 0.71 (CI: 0.69-0.74) for ARB/ACEi in patients with CLTI, and 0.22 (CI: 0.20-0.24) for AP, 0.38 (CI: 0.35-0.42) for LLA, and 1.17 (CI: 1.08-1.27) for ARB/ACEi in patients with CLTI + MI. Adjusted analyses showed similar results. Compared with patients with MI, adjusted 3-year hazard ratios for mortality were 1.69 (CI: 1.64-1.74) in patients with CLTI and 1.60 (CI: 1.51-1.69) in patients with CLTI + MI. Conclusion: Patients with CLTI were undertreated with EBM and carried a more adverse prognosis, as compared with patients with MI, despite similar guidelines.
AB - Aims: To describe the practice patterns of evidence-based medical therapy (EBM) and overall mortality in high-risk patients with critical limb-threatening ischaemia (CLTI), compared with patients with myocardial infarction (MI). Methods and results: Using Danish registries, we identified patients 40-100 years of age with a first-time hospitalization for CLTI or MI from 2008-2018 and grouped them into CLTI, MI, and CLTI and history of MI (CLTI + MI). We examined the likelihood of filling prescriptions with EBM [i.e. antiplatelets (Aps), lipid-lowering agents (LLAs), angiotensin-converting enzyme inhibitor (ACEi), or angiotensin II-receptor blockers (ARBs)] within 3 months after discharge among survivors. Further, we assessed the adjusted 3-year mortality rates. We included 92 845 patients: 14 941 with CLTI (54.7% male), 74 830 with MI (64.6% male) and 3,074 with CLTI + MI (65.2% male). Patients with CLTI and CLTI + MI were older and had more comorbidities than patients with MI. Compared with patients with MI, the unadjusted odds ratios of filling prescriptions were 0.15 [confidence interval (CI): 0.14-0.15] for AP, 0.26 (CI: 0.25-0.27) for LLA, and 0.71 (CI: 0.69-0.74) for ARB/ACEi in patients with CLTI, and 0.22 (CI: 0.20-0.24) for AP, 0.38 (CI: 0.35-0.42) for LLA, and 1.17 (CI: 1.08-1.27) for ARB/ACEi in patients with CLTI + MI. Adjusted analyses showed similar results. Compared with patients with MI, adjusted 3-year hazard ratios for mortality were 1.69 (CI: 1.64-1.74) in patients with CLTI and 1.60 (CI: 1.51-1.69) in patients with CLTI + MI. Conclusion: Patients with CLTI were undertreated with EBM and carried a more adverse prognosis, as compared with patients with MI, despite similar guidelines.
KW - Best medical therapy
KW - Critical limb-threatening ischaemia
KW - Evidence-based medical therapy
KW - Guideline-recommended medical therapy
KW - Myocardial infarction
U2 - 10.1093/eurjpc/zwad022
DO - 10.1093/eurjpc/zwad022
M3 - Journal article
C2 - 36708037
AN - SCOPUS:85164013670
VL - 30
SP - 1092
EP - 1100
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 11
ER -
ID: 396094970