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Table 3 Summary of recommendations on treatments of asymptomatic PAD

From: Critical appraisal of international guidelines for the screening and treatment of asymptomatic peripheral artery disease: a systematic review

 

Objective

Smoking cessation

Healthy diet and physical activity

Lipid lowering

Hypertension treatment

Diabetes treatments

Antiplatelet therapy

Arterial reconstruction

ACCF AHA

Management of PAD

Recommended

 

Recommended

Recommended; ACEi may be considered

Recommended

Asymptomatic LEAD: Indicated; Asymptomatic PAD with ABI (0.91-0.99): Usefulness is not well established

Not indicated as prophylactic therapy

ACCP

Antithrombotic Therapy in PAD

     

Asymptomatic PAD: Aspirin 75 to 100 mg daily

 

AHA ACC

Management of LEAD

     

Asymptomatic PAD (ABI≤0.90): Reasonable; Asymptomatic PAD with ABI (0.91-0.99): Uncertain

 

BWG

Diagnosis and treatment of PAD

Recommended

 

Stains: LDL-C< 100 mgdl If high risk, LDL-C < 70 mgdl

BP<140/90 mmHg; BP <130/80 mmHg if diabetes renal insufficiency

HbA1c < 7%, as low as possible

All PAD patients: ASA (75-150 mg) ASA is contra-indicated new CV event under ASA treatment: Clopidogrel (Plavix® 75 mg)

 

CEVF

Management of IC

Recommended

 

Recommended

Recommended

Recommended

Asymptomatic LEAD: Indicated

 

ESC

Diagnosis and treatment of PAD

Recommended

Recommended

Stains LDL-C <70mgdL; If initial LDL-C level is 70-135mgdL, decreased by >50%

Recommended

Recommended

Not routinely indicated in isolated asymptomatic LEAD

 

GSA

Diagnosis and treatment of PAOD

      

Not indicated for Asymptom-atic PAOD

ISD

Treatment of PAD in diabetes

     

Diabetic + aged >50 years+ asymptomatic PAD: Long-term daily aspirin (75-100 mg)

 

KSIR

Interventional Recanalization of Lower Extremity Arteries

      

Not require prophylactic Recanalization

SVS

Management of asymptomatic atherosclerotic occlusive disease of the lower extremities and claudication

Recommended (repeatedly until tobacco use has stopped)

     

Against invasive treatments for PAD in the absence of symptoms

TASC

Management of PAD

  

LDL-C <100mgdl

    
  1. Abbreviations: ABI Ankle Brachial Index, ACEI Angiotensin-converting Enzyme Inhibition, ACCF AHA American College of Cardiology Foundation, American Heart Association Task Force, ACCP American College of Chest Physicians, AGREE Appraisal of Guidelines Research and Evaluation, AHA ACC American College of Cardiology, American Heart Association Task Force, ASA Acetylsalicylic Acid, BP Blood Pressure, BWG Belgian Working Group, CEVF Central European Vascular Forum, CV Cardiovascular, ESC European Society of Cardiology, GSA German Society of Angiology, HbA1c Glycosylated Hemoglobin, IC Intermittent Claudication, ISD Italian Societies of Diabetes, LDL-C Low-density Lipoprotein Cholesterol, LEAD Lower Extremity Arterial Disease, KSIR Korean Society of Interventional Radiology, PAD Peripheral Arterial Disease, PAOD Peripheral Arterial Occlusive Disease, SVS Society for Vascular Surgery, TASC Inter-Society Consensus for the Management of Peripheral Arterial Disease