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02-05-2024 | Peripheral Arterial Disease | Peripheral Vascular Disease (S Kinlay, Section Editor)

Medical Therapy for Peripheral Artery Disease

Authors: Mario Enrico Canonico, Connie N. Hess, R. Kevin Rogers, Marc P. Bonaca

Published in: Current Cardiology Reports

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Abstract

Purpose of Review

Patients with lower extremity peripheral artery disease (PAD) are at high risk for major adverse cardiovascular events (MACE) and major adverse limb events (MALE). This manuscript will review the current evidence for medical therapy in patients with PAD according to different clinical features and the overall cardiovascular (CV) risk.

Recent Findings

The management of PAD encompasses non-pharmacologic strategies, including lifestyle modification such as smoking cessation, supervised exercise, Mediterranean diet and weight loss as well as pharmacologic interventions, particularly for high risk patients. Benefits for reduction of CV and limb outcomes have been demonstrated for new therapies, including antithrombotic therapy (i.e., low-dose rivaroxaban plus aspirin), lipid lowering therapy (i.e., proprotein convertase subtilisin/kexin type 9 inhibitors), and glucose lowering therapy (i.e., sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists). However, the adoption of these therapies in PAD remains suboptimal in practice. Implementation science studies have recently shown promising results in PAD patients.

Summary

Comprehensive medical and non-medical management of PAD patients is crucial to improving patient outcomes, mitigating symptoms, and reducing the risk of MACE and MALE. A personalized approach, considering the patient's overall risk profile and preference, is essential for optimizing medical management of PAD.
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Metadata
Title
Medical Therapy for Peripheral Artery Disease
Authors
Mario Enrico Canonico
Connie N. Hess
R. Kevin Rogers
Marc P. Bonaca
Publication date
02-05-2024