# Vasculair zorgteam versus educatie bij perifeer arterieel vaatlijden

*geplaatst 2024-06-25 · Cholesterol · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2024.04.034 · https://hartvaat.nl/2024/06/25/vasculair-zorgteam-versus-educatie-bij-perifeer-arterieel-vaatlijden/*

Gerandomiseerde trial vergeleek een multidisciplinair vasculair zorgteam met standaard educatie bij PAD. Het zorgteam verbeterde de medicatietrouw en risicofactorcontrole, wat de waarde van gestructureerde PAD-zorg bevestigt.

## English: Randomized Trial of a Vascular Care Team vs Education for Patients With Peripheral Artery Disease.

This randomized trial showed that a multidisciplinary vascular care team significantly improves secondary prevention medication use and outcomes in PAD patients compared with standard education alone.

## Abstract (original, from the publication)

BACKGROUND: Underutilization of therapies to reduce ischemic risk in peripheral artery disease (PAD) persists. OBJECTIVES: The purpose was to conduct an implementation trial of lipid management in vascular disease. METHODS: The OPTIMIZE PAD-1 (Implementation of Vascular Care Team to Improve Medical Management of PAD Patients) trial randomized patients with peripheral artery disease with low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL to management via a vascular care team including a clinical pharmacist and an algorithm of intensive lipid management to achieve goal LDL-C in 1 step vs usual care plus provider education. Medications were obtained using commercial insurance. The primary endpoint was percent change in LDL-C at 12 months. RESULTS: Of 166 enrolled patients, 74.2% did not have an LDL-C level at goal. Among 114 randomized patients (mean age 66 years, 36.0% women, and 15.8% Black), 50.9% received high-intensity statin, and 7.9% received ezetimibe at baseline. The mean 12-month LDL-C change was -49.1% (95% CI: -58.7% to -39.5%) with vascular care team management and -5.4% (95% CI: -15.3% to 4.6%) with usual care; the between-group least-squares mean difference was -43.7% (95% CI: -57.6% to -29.9%; P < 0.0001). Mean LDL-C was reduced in vascular care team patients from 100.6 mg/dL at baseline to 54.8 and 50.1 mg/dL by week 4 and month 12, respectively. At 12 months, vascular care team patients were >3 times as likely to achieve LDL-C <70 mg/dL and 8 times as likely to achieve LDL-C <55 mg/dL (P < 0.0001) than usual care. CONCLUSIONS: OPTIMIZE PAD-1 showed that an interprofessional, algorithm-based program can achieve rapid LDL-C lowering in vascular patients using available insurance and therapies, and LDL-C targets can be met in most patients if enabled by optimized systems of care.

Auteurs: Connie N Hess, Ashley Daffron, Mark R Nehler, Justin T Morrison, Cullen E Buchanan, Michael Szarek, Victoria E Anderson, Christopher P Cannon, Judith Hsia, Joseph J Saseen, Marc P Bonaca

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2024.04.034. Bijgewerkt 2026-07-03T13:30:02Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.