Which type of patients with asymptomatic peripheral arterial disease with an ABI score of less than 0.9, is it reasonable to offer antiplatelet and statin therapy to?
For a patient less than 75 years of age with asymptomatic peripheral arterial disease (PAD), which of the following would you recommend?
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This is an important question. Unfortunately, there is no good evidence to help answer it. So what I am about to say is not evidence-based, but it is common sense. Since patients with PAD have an increased rate of MI, Stroke, and CV death, they should all receive maximum medical therapy. I believe that they should be treated with a statin to lower the LDL below 70 and closer to 50. At least, I would also treat with ASA 81 mg daily. I do not think I would add the COMPASS dose of rivaroxiban, whic...
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More information is needed. Why were ABIs obtained if the patient is asymptomatic? How old is the patient and what are the patient's CVD risk factors?
I agree that a statin is reasonable for most patients under age 75 with asymptomatic PAD. For those age 75 or older, shared decision-making would be appropriate.
Regarding aspirin (ASA), the question is whether the potential benefits would outweigh the potential risks (i.e., bleeding). If the patient is under 75, a coronary calcium score (CCS) m...
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