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Peripheral Artery Disease

Posted almost 2 years ago by Camille Dyer

COURTESY Save Lives and Limbs

Courtesy of APAC

What You Should Really Know About Peripheral Artery Disease (PAD)

Phase II- Diagnosis
Have you asked yourself why you are not performing or ordering ABIs on all patients you see who have PAD risk factors or symptoms?

So, what should you do with patients who have risk factor(s) of PAD you might ask? 

If you have a patient with risk factor(s), the AHA, ACC and ADA all recommend doing an Ankle Brachial Index (ABI) even if the patient does not complain of claudication. The ABI is 95% accurate for diagnosing PAD.
Keep Reading About PAD Diagnosis Here
2022 Reimbursement Rates For ABIs
Why Don't Primary Care Providers Perform or Order ABIs?
Learn More Here
Learn to identify signs and symptoms of Peripheral Artery Disease (PAD) and develop a treatment plan including guideline-directed medical therapy (GDMT) with the Peripheral Artery Disease: Optimizing Treatment Strategies online course. Join Aaron W. Aday, MD and Demetria McNeal, MBA, PhD for Mitigating Health Disparities in Peripheral Artery Disease, an interactive lesson highlighting strategies to ensure equitable access to optimal patient care. Earn 0.25 CME/CNE/MOC credits with a certified patient case, A Case of a Non-healing Toe Wound and Rest Pain.
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Journal Review

By APAC Treasurer Michael Clark, DMSc, Ph.D., PA, FACC, DFAAPA

PCSK9 Inhibitor and Statin Improve Plaque Regression and Stabilization and More!

PACMAN-AMI trial was presented at ACC 2022 and the study published in JAMA in April of this year.  This trial included about 300 enrollees presenting with an acute MI (STEMI and NSTEMI) and requiring PCI.  This was a randomized trial where all participants received a high intensity Rosuvastatin (20 mg) but in a 1:1 fashion, one group received 150 mg Alirocumab subcutaneous every 2 weeks and the other group placebo.
  The first treatments started within 24 hours of the PCI. The participants were followed out to 52 weeks. The primary endpoint was reduction of mean atheromatous plaque volume. The study met its primary endpoint showing significant atheromatous plaque volume reduction as well secondarily significant plaque stabilization including thickening of the fibrous plaque roof in the Alirocumab/Rosuvastatin compared to Placebo/Rosuvastatin.
There was less clinical events in both groups.  As expected, the LDL in the PCSK9/Statin group had an 85% lowering of LDL compared to the Placebo group.  Now plaque stability and volume reduction has been seen in previous trials with PCSK9’s and Statins alone.  Maybe the real story from this small trial is supporting the message that lower LDL reduction is better especially when we get LDL to 50 or below.  Interestingly it’s not the first time we have seen this cardiovascular protective relationship with LDL lowering less then 55.  
Read The Full Article Here

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