CONGRESS ABSTRACT

Aim: Low-density lipoprotein (LDL) cholesterol is a modifiable risk factor for cardiovascular disease and peripheral arteriopathy. Our aim is to present a real-world analysis of lipid profile and lipid-lowering therapy in patients admitted to our vascular surgery department, for invasive treatment of peripheral artery disease (PAD). Methods: We enrolled 399 patients from January 2023 to February 2024: 236 with lower limbs arteriopathy and 163 with carotid arteriopathy. Clinical features and LDL value were collected. The percentage of patients receiving statin therapy and the variables associated with increased statins use and achievement of the LDL target were evaluated. A multiple linear regression investigated the correlation of LDL values ​​with different clinical variables. Results: Cardiovascular risk factors and prevalence of coronary artery disease (CAD) and lower limbs and/or carotid atheromasia are listed in table 1. Of the 399 patients, only 259 (65%) were on statin therapy. Comparing patients with and without statin therapy, the former presents a statistically significant higher prevalence of diabetes (44.4%vs27.9%, p=0.001), hypertension (83%vs70.7%, p=0.005), dyslipidemia (67.2%vs34.3%, p<0.001), CAD history (44%vs18.6%, p<0.001) and carotid atheromasia (64%vs51.4%, p=0.49). PAD was more prevalent in the group not on statin therapy (72.8% vs 60%, p =0.020). The average LDL value was 91 mg/dl. At multivariate linear regression analysis diabetes, CAD history and statin therapy were identified as independently associated with average LDL levels (figure 1). Patients with a target LDL at admission, were 89 (22% of overall population). Dividing patients into two groups according to the achievement of the LDL target, it was highlighted that patients reaching an LDL <55 mg/dl had a more prevalence of diabetes (p=0.036), CAD history (p<0.001) and statin use (p<0.001) (table 2).  Conclusion: Our analysis highlights how in a population at very high cardiovascular risk, the percentage of patients undergoing statin therapy was much lower than expected and even among the latter only a smaller percentage presented target LDL values. The association of diabetes and CAD with lower LDL values ​​and greater statin use may be related with a multidisciplinary assessment of these patients and greater attention to lipid-lowering therapy in CAD patients than in PAD patients.