ArticleAnnals of vascular surgery2026
Impact of Preoperative LDL Level on Lower Extremity Revascularization Outcomes.
Article in Annals of vascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecent guidelines recommend achieving low-density lipoprotein (LDL) < 70 mg/dL in patients with peripheral arterial disease (PAD). This study assesses the trends in LDL testing and its impact on lower extremity revascularization (LER) outcomes in a tertiary center.
methodsA retrospective chart review of patients who underwent open, endovascular, or hybrid LER between 2013 and2020 was performed, with follow-up extending into 2024. Patients were divided into 2 groups based on baseline LDL < 70 mg/dL or higher prior to LER. Characteristics and outcomes of the 2 groups were compared.
resultsOf 2,039 patients that underwent LER, 33.1% did not have LDL testing prior to intervention. The proportion of patients with preoperative LDL testing significantly increased over the study period (39.3-66.2%) concomitantly with increased statin use (74.4-81%), while the proportion of patients with baseline LDL < 70 mg/dL remained low (∼36%). Patients with low LDL were more likely to be older White males with significantly higher burden of comorbidities treated for chronic limb-threatening ischemia. Survival and Cox regression analysis did not demonstrate significant association of baseline LDL < 70 mg/dL with major adverse cardiovascular events, limb events, or mortality.
conclusionLipid testing and statin use prior to LER have increased, but most patients had baseline LDL higher than the suggested target by most recent guidelines. A preoperative LDL < 70 mg/dL did not demonstrate an association with outcomes. This study highlights a significant gap in the care of patients with PAD undergoing LER and an opportunity for improvement by application of contemporary guidelines.
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