OBJECTIVE: We compared the use of secondary prevention among patients with a first-time hospitalisation for peripheral arterial disease (PAD) of the lower limb with that among patients with a first-time hospitalisation for myocardial infarction (MI). DESIGN AND MATERIALS: Population-based follow-up study between 1997 and 2003 using registry data from the counties of Northern Jutland, Aarhus and Viborg, Denmark. RESULTS: Between 1997 and 2003, within 180 days after hospital discharge, 26% of patients with lower limb PAD (n=3,424) used antiplatelet drugs, 10% statins, 22% ACE-inhibitors/AT-II receptor antagonists and 13% betablockers compared with 55%, 46%, 42% and 78% respectively among patients with MI (n=11,927). Patients with PAD were substantially less likely than patients with MI to use antiplatelet drugs [adjusted relative risk (RR)=0.39 (95% confidence interval (CI): 0.36-0.41)], statins [adjusted RR=0.21 (95% CI: 0.19-0.23)], ACE-inhibitors/AT-II receptor antagonists [adjusted RR=0.43 (95% CI: 0.40-0.47)] and beta-blockers [adjusted RR=0.10 (95% CI: 0.09-0.11). Between 1997 and 2003 secondary prevention increased considerably in both patient groups, but the disparity in treatment persisted. CONCLUSIONS: Efforts to further increase secondary prevention among patients with PAD are needed urgently.
OBJECTIVE: We compared the use of secondary prevention among patients with a first-time hospitalisation for peripheral arterial disease (PAD) of the lower limb with that among patients with a first-time hospitalisation for myocardial infarction (MI). DESIGN AND MATERIALS: Population-based follow-up study between 1997 and 2003 using registry data from the counties of Northern Jutland, Aarhus and Viborg, Denmark. RESULTS: Between 1997 and 2003, within 180 days after hospital discharge, 26% of patients with lower limb PAD (n=3,424) used antiplatelet drugs, 10% statins, 22% ACE-inhibitors/AT-II receptor antagonists and 13% betablockers compared with 55%, 46%, 42% and 78% respectively among patients with MI (n=11,927). Patients with PAD were substantially less likely than patients with MI to use antiplatelet drugs [adjusted relative risk (RR)=0.39 (95% confidence interval (CI): 0.36-0.41)], statins [adjusted RR=0.21 (95% CI: 0.19-0.23)], ACE-inhibitors/AT-II receptor antagonists [adjusted RR=0.43 (95% CI: 0.40-0.47)] and beta-blockers [adjusted RR=0.10 (95% CI: 0.09-0.11). Between 1997 and 2003 secondary prevention increased considerably in both patient groups, but the disparity in treatment persisted. CONCLUSIONS: Efforts to further increase secondary prevention among patients with PAD are needed urgently.
Authors: Florian Kirsch; Christian Becker; Christoph Kurz; Lars Schwettmann; Anja Schramm Journal: BMC Health Serv Res Date: 2020-12-20 Impact factor: 2.655
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