| Medication underuse during long-term follow-up in patients with peripheral arterial disease. | |
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MedLine Citation:
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PMID: 20031859 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with peripheral arterial disease constitute a high-risk population. Guideline-recommended medical therapy use is therefore of utmost importance. The aims of our study were to establish the patterns of guideline-recommended medication use in patients with PAD at the time of vascular surgery and after 3 years of follow up, and to evaluate the effect of these therapies on long-term mortality in this patient group. METHODS AND RESULTS: Data on 711 consecutive patients with peripheral arterial disease undergoing vascular surgery were collected from 11 hospitals in the Netherlands (enrollment between May and December 2004). After 3.1+/-0.1 years of follow-up, information on medication use was obtained by a questionnaire (n=465; 84% response rate among survivors). Guideline-recommended medical therapy use for the combination of aspirin and statins in all patients and beta-blockers in patients with ischemic heart disease was 41% in the perioperative period. The use of perioperative evidence-based medication was associated with a reduction of 3-year mortality after adjustment for clinical characteristics (hazard ratio, 0.65; 95% CI, 0.45 to 0.94). After 3 years of follow-up, aspirin was used in 74%, statins in 69%, and beta-blockers in 54% of the patients respectively. Guideline-recommended medical therapy use for the combination of aspirin, statins, and beta-blockers was 50%. CONCLUSIONS: The use of guideline recommended therapies in the perioperative period was associated with reduction in long-term mortality in patients with peripheral arterial disease. However, the proportion of patients receiving these evidence-based treatments-both at baseline and 3 years after vascular surgery-was lower than expected based on the current guidelines. These data highlight a clear opportunity to improve the quality of care in this high-risk group of patients. |
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Authors:
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Sanne E Hoeks; Wilma J M Scholte op Reimer; Yvette R B M van Gestel; Olaf Schouten; Mattie J Lenzen; Willem-Jan Flu; Jan-Peter van Kuijk; Corine Latour; Jeroen J Bax; Hero van Urk; Don Poldermans |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-04-24 |
Journal Detail:
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Title: Circulation. Cardiovascular quality and outcomes Volume: 2 ISSN: 1941-7705 ISO Abbreviation: Circ Cardiovasc Qual Outcomes Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-12-24 Completed Date: 2010-03-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101489148 Medline TA: Circ Cardiovasc Qual Outcomes Country: United States |
Other Details:
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Languages: eng Pagination: 338-43 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aged Aspirin / therapeutic use Cardiovascular Agents / therapeutic use* Drug Therapy, Combination Evidence-Based Medicine / statistics & numerical data Female Follow-Up Studies Guideline Adherence / statistics & numerical data* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Male Middle Aged Myocardial Ischemia / drug therapy, mortality Peripheral Vascular Diseases / drug therapy*, mortality* Platelet Aggregation Inhibitors / therapeutic use Practice Guidelines as Topic Prognosis Registries Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Cardiovascular Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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