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Journal Article Ppublish 1 citation

PubMed: 37806655 DOI: 10.1016/j.avsg.2023.08.023

Update About the Management of Low-Density Lipoprotein Cholesterol and Hypertriglyceridemia in Lower Extremity Peripheral Artery Disease Patients: Consensus of the French Society of Vascular Medicine and the French Society for Vascular and Endovascular Surgery.

Ann Vasc Surg 100:148-154

Authors: Guillaume Mahé, Gudrun Boge, Alessandra Bura-Rivière, Nabil Chakfé, Joël Constans, Yann Goueffic, Philippe Lacroix, Claire Le Hello, Gilles Pernod, Antonia Perez-Martin, Jean Picquet, Muriel Sprynger

Affiliations

  • Vascular Medicine Department, Radiology and Medical Imaging Department, Rennes University Hospital Centre, Rennes, France.
  • Vascular Medicine Department, Montpellier University Hospital Centre, Montpellier, France.
  • Vascular Medicine Department, Toulouse University Hospital Centre, Rangueil Hospital, Toulouse, France.
  • Vascular Surgery and Kidney Transplantation Department, Strasbourg University Hospital Centre, Strasbourg, France.
  • Vascular Medicine Department, Bordeaux University Hospital Centre, Saint André Hospital, Bordeaux, France.
  • Vascular Surgery Department, Saint-Joseph Paris Hospital Group, Paris, France.
  • Vascular Medicine Department, Limoges University Hospital Centre, Limoges, France.
  • Vascular Medicine Department, Saint-Etienne University Hospital, Saint-Etienne, France.
  • Vascular Medicine Department, Grenoble University Hospital Centre, Grenoble, France.
  • Vascular Investigation and Vascular Medicine Department, Nimes University Hospital Centre, Nimes, France.
  • Vascular and Thoracic Surgery Department, Angers University Hospital Centre, Angers, France.
  • Cardiology Department, Sart Tilman University Hospital Centre, Liège, Belgium.

Abstract

BACKGROUND

A French intersociety consensus on behalf the Société Française de Médecine Vasculaire and the Société de Chirurgie Vasculaire et Endovasculaire was proposed in 2021 for the management of patients with lower extremity peripheral artery disease (LEAD). Recent studies have been published and an update of this consensus about the management of low-density lipoprotein cholesterol (LDLc) and hypertriglyceridemia was required.

METHODS

A steering committee of 12 vascular physicians and surgeons defined questions of interest about LDLc and hypertriglyceridemia management. A French expert panel voted the proposals. Consensus was considered to have been achieved if more than 80% of the responses corresponded to either "Agreement" or "Disagreement".

RESULTS

Among the 56 experts who were asked to participate, 46 (82%) accepted. After the first round of the Delphi procedure, the 4 proposals reached consensus. The following suggestions and recommendations were approved: 1. For LEAD patients treated by the highest tolerated statin dose ± ezetimibe and who have an LDLc ≥0.70 g/L, we recommend adding a proprotein convertase subtilisin/kexin type 9 inhibitor. 2. For LEAD patients treated by statin and who have elevated triglyceride level between ≥150 mg/dL and ≤500 mg/dL, we suggest adding Icosapent Ethyl. 3. Before adding Icosapent Ethyl in LEAD patients treated with statin, we suggest looking for symptoms that may suggest atrial fibrillation. 4. For LEAD patients treated by Icosapent Ethyl and who have symptoms that suggest atrial fibrillation, we recommend performing an electrocardiogram.

CONCLUSIONS

This update will help clinicians to improve LEAD patient management.

MeSH

Cholesterol, Ldl, Lipoproteins, Arteries, Hypertriglyceridemia, Atrial Fibrillation, Signs And Symptoms, Cholesterol, Peripheral Arterial Disease, Hydroxymethylglutaryl-Coa Reductase Inhibitors, Vascular Surgical Procedures, Lipoproteins, Ldl, Triglycerides

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