Lipid management in patients newly referred to a vascular surgery outpatient clinic

<h2>Abstract</h2><h3>Objective</h3> To evaluate the lipid management of patients with atherosclerotic vascular disease at the time of first outpatient vascular surgery consult to identify potential opportunities for improved dyslipidemia pharmacotherapy and monitoring. <h3>Methods</h3> Retrospective chart review of 100 new non-emergent referrals to a vascular surgery clinic was performed. Inclusion criteria were adults referred for a noncardiac atherosclerotic vascular disease: carotid disease, peripheral arterial disease of the upper or lower extremity, abdominal aortic aneurysm or penetrating aortic ulcer, chronic aortic dissection, and visceral artery thrombosis or occlusion. Nonatherosclerotic pathologies and patients who had previous vascular surgery consult were excluded. Current lipid pharmacotherapy and most recent lipid panel were recorded. <h3>Results</h3> One hundred patients with an average age of 74.1 ± 7.82 years were included. The mean low-density-lipoprotein cholesterol (LDL-C) within the cohort was 2.05 ± 1.01 mmol/L. Compared with the Canadian Cardiovascular Society guideline target of 1.8 mmol/L, 41% of patients were above target, 38% were within target, and 20% did not have a recent lipid panel. When categorized by intensity of statin therapy, 40% of patients were on high-intensity, 35% were on moderate-intensity, 4% were on low-intensity, and 21% were on no statin. There was no statistically significant difference in LDL-C when comparison between referral groups was performed, χ²(3) = 2.384; <i>P</i> = .497. A significant association was found between referral reason and statin intensity, χ²(12) = 143.447; <i>P</i> < .001. <h3>Conclusions</h3> Our study demonstrated that only 38% of patients referred to our vascular surgery clinic met the recommended target LDL-C of <1.8 mmol/L, even though 79% of all patients were on statin therapy. This represents a gap in lipid management and presents an opportunity for vascular surgeons to contribute to the medical management of patients with atherosclerotic vascular disease. Future research should explore strategies for optimizing vascular surgeons' involvement in the management of dyslipidemia.