Clinical Profile and Management of Patient Patients with Ischemic Heart Disease and/or Peripheral Artery Disease in Clinical Practice: The APALUSA Study

Vivencio Barrios; Carlos Escobar; Carmen Suarez; Xavier Garcia-Moll; Francisco Lozano

doi:10.3390/jcm11123554

Clinical Profile and Management of Patient Patients with Ischemic Heart Disease and/or Peripheral Artery Disease in Clinical Practice: The APALUSA Study

J Clin Med. 2022 Jun 20;11(12):3554. doi: 10.3390/jcm11123554.

Authors

Vivencio Barrios¹, Carlos Escobar², Carmen Suarez³, Xavier Garcia-Moll⁴, Francisco Lozano⁵

Affiliations

¹ Cardiology Department, University Hospital Ramon y Cajal, 28034 Madrid, Spain.
² Cardiology Department, University Hospital La Paz, 28046 Madrid, Spain.
³ Internal Medicine Department, University Hospital la Princesa, 28006 Madrid, Spain.
⁴ Cardiology Department, University Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
⁵ Vascular Surgery Department, University Hospital Clínico, 37007 Salamanca, Spain.

Abstract

This study was aimed to ascertain the clinical profile and management of patients with ischemic heart disease (IHD) and/or peripheral artery disease (PAD). In this observational and cross-sectional study developed in 80 hospitals throughout Spain, consecutive adults with stable IHD and/or PAD were included. A total of 1089 patients were analyzed, of whom 65.3% had only IHD, 17.8% PAD and 16.9% both. A total of 80.6% were taking only one antiplatelet agent, and 18.2% were on dual antiplatelet therapy (mainly aspirin/clopidogrel). Almost all patients were taking ≥1 lipid lowering drug, mainly moderate-to-high intensity statins. IHD patients took ezetimibe more commonly than PAD (43.9% vs. 12.9%; p < 0.001). There were more patients with IHD that achieved blood pressure targets compared to PAD (<140/90 mmHg: 67.9% vs. 43.0%; p < 0.001; <130/80 mmHg: 34.1% vs. 15.7%; p < 0.001), LDL-cholesterol (<70 mg/dL: 53.1% vs. 41.5%; p = 0.033; <55 mg/dL: 26.5% vs. 16.0%; p = 0.025), and diabetes (HbA1c < 7%, with SGLT2i/GLP1-RA: 21.7% vs. 8.8%; p = 0.032). Modifications of antihypertensive agents and lipid-lowering therapy were performed in 69.0% and 82.3% of patients, respectively, without significant differences between groups. The use of SGLT2i/GLP1-RA was low. In conclusion, cardiovascular risk factors control remains poor among patients with IHD, PAD, or both. A higher use of combined therapy is warranted.

Keywords: LDL cholesterol; antiplatelet therapy; blood pressure; cardiovascular; diabetes; ischemic heart disease; peripheral artery disease.

Grants and funding

Financial support for this research was provided by Bayer Hispania S.L. which has no role in the design of the study; collection, analysis, and interpretation of data; either in the manuscript writing.