Lifestyle Changes Maximize PAD Surgery Success

PAD surgery complications reduced by presurgery aspirin, statins and quitting smoking

(RxWiki News) Scheduling surgery for a blocked leg artery? You may be able to do more than you think to ensure your procedure is a success. Simple lifestyle changes prior to an operation appear to lower the risk of complications and reduce the chance of a repeat surgery.

Patients that quit smoking, and take both aspirin and a cholesterol-lowering statin medication before treatment for a blocked leg artery, also known as peripheral artery disease (PAD), were found to have a reduced future risk of serious complications such as surgery to salvage limbs or amputation.

"Discuss lifestyle changes with your doctor before taking action."

P. Michael Grossman, MD, a co-author of the study and an interventional cardiologist at the University of Michigan Cardiovascular Center, noted that when patients were admitted to the hospital, 47 percent were on aspirin, a type of statin, and didn't smoke. At discharge, that number jumped to 71 percent, including smokers who had received smoking cessation counseling.

Dr. Grossman said the improvement in statin prescriptions prior to discharge signifies a missed opportunity to provide life-saving intervention to PAD patients.

“Although a considerable effort has been focused on the impact of guideline adherence in patients with heart attack and heart failure, there are currently no such national programs focused on patients with PAD,” he said.

During the study, researchers reviewed a Michigan-based insurance database, following 1,357 PAD patients between January 2007 and December 2009.

The patients were seeking relief from leg pain and cramping and were treated with elective angioplasty, a surgical procedure to open clogged leg arteries and restore blood flow to the legs.

Prior to the procedure, 85 percent of patients took aspirin, 76 percent took statins and 65 percent avoided smoking, but less than half did all three. Patients were not found to have a difference in heart events such as heart attack or stroke upon hospital admission — regardless of whether they took medications or abstained from smoking.

Six months after surgery, investigators found that individuals who avoided smoking, and took aspirin and statins were able to reduce their risk of limb salvage surgery, amputation or a repeat procedure by more than half, as compared to those who didn't make lifestyle changes.

Patients who didn't make changes had a 16 percent risk versus a 7 percent risk among those who took medication and quit smoking.

Researchers suggested that additional studies are needed to determine why interventions such as medication and quitting smoking remain underused among high-risk PAD patients.

Two study authors received funding from Blue Cross Blue Shield of Michigan and the National Institutes of Health for the research.

The study, which was funded by Blue Cross Blue Shield of Michigan, was recently published in Circulation: Cardiovascular Interventions, an American Heart Association journal.

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Review Date: 
January 2, 2013