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.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
06 Oct 2023
Historique:
received: 30 03 2023
revised: 09 08 2023
accepted: 10 08 2023
pubmed: 9 10 2023
medline: 9 10 2023
entrez: 8 10 2023
Statut: aheadofprint

Résumé

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. 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". 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. This update will help clinicians to improve LEAD patient management.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
This update will help clinicians to improve LEAD patient management.

Identifiants

pubmed: 37806655
pii: S0890-5096(23)00679-9
doi: 10.1016/j.avsg.2023.08.023
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Thomas Behar (T)
Xavier Bérard (X)
Christophe Bonnin (C)
Christophe Breteau (C)
Dominique Brisot (D)
Franck Chleir (F)
Clarisse Choquenet (C)
Raphael Coscas (R)
Grégoire Detriché (G)
Marie Elias (M)
Khalil Ezzaki (K)
Patrick Feugier (P)
Sandrine Fiori (S)
Sébastien Gaertner (S)
Catherine Gaillard (C)
Céline Gaudout (C)
Charles-Emmanuel Gauthier (CE)
Yannick Georg (Y)
Adrien Hertault (A)
Elixène Jean-Baptiste (E)
Adrien Kaladji (A)
Joëlle Laffont (J)
Damien Lanéelle (D)
Jean-Pierre Laroche (JP)
Anne Lejay (A)
Tiphanie Loric (T)
Anne-Laure Madika (AL)
Betty Magnou (B)
Jean-Patrick Maillard (JP)
Julie Malloizel-Delaunay (J)
Gilles Miserey (G)
Alain Moukarzel (A)
Claire Mounier-Vehier (C)
Bahaa Nasr (B)
Marie-Line Nelzy (ML)
Philippe Nicolini (P)
Jacques-Yves Phelipot (JY)
Jean Sabatier (J)
Simon Soudet (S)
Anne Tissot (A)
Laurent Tribout (L)
Jean-Claude Wautrecht (JC)
Charles Zarca (C)
Anne Zuber (A)

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Guillaume Mahé (G)

Vascular Medicine Department, Radiology and Medical Imaging Department, Rennes University Hospital Centre, Rennes, France. Electronic address: maheguillaume@yahoo.fr.

Gudrun Boge (G)

Vascular Medicine Department, Montpellier University Hospital Centre, Montpellier, France.

Alessandra Bura-Rivière (A)

Vascular Medicine Department, Toulouse University Hospital Centre, Rangueil Hospital, Toulouse, France.

Nabil Chakfé (N)

Vascular Surgery and Kidney Transplantation Department, Strasbourg University Hospital Centre, Strasbourg, France.

Joël Constans (J)

Vascular Medicine Department, Bordeaux University Hospital Centre, Saint André Hospital, Bordeaux, France.

Yann Goueffic (Y)

Vascular Surgery Department, Saint-Joseph Paris Hospital Group, Paris, France.

Philippe Lacroix (P)

Vascular Medicine Department, Limoges University Hospital Centre, Limoges, France.

Claire Le Hello (C)

Vascular Medicine Department, Saint-Etienne University Hospital, Saint-Etienne, France.

Gilles Pernod (G)

Vascular Medicine Department, Grenoble University Hospital Centre, Grenoble, France.

Antonia Perez-Martin (A)

Vascular Investigation and Vascular Medicine Department, Nimes University Hospital Centre, Nimes, France.

Jean Picquet (J)

Vascular and Thoracic Surgery Department, Angers University Hospital Centre, Angers, France.

Muriel Sprynger (M)

Cardiology Department, Sart Tilman University Hospital Centre, Liège, Belgium.

Classifications MeSH