Management of peripheral arterial disease patients: comparing the ACC/AHA and TASC-II guidelines

ABSTRACT

Background: Peripheral arterial disease (PAD) is a common manifestation of systemic atherosclerosis associated with a high risk of morbidity and mortality from cardiovascular events. Despite this, PAD is often undiagnosed and, therefore, undertreated.

Objective: The purpose of this review is to highlight and provide clinical insight into the similarities and differences between the available PAD treatment guidelines developed by the American College of Cardiology/American Heart Association (ACC/AHA) and the Trans-Atlantic Inter-Society Consensus II (TASC II) working group.

Methods: Recommendations from the ACC/AHA 2005 Practice Guidelines for the Management of Patients with Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) and TASC II Inter-Society Consensus for the Management of Peripheral Arterial Disease, initiated in 2004 and published in 2007, were compared. Supplemental information was obtained by searching the PubMed and MEDLINE databases using relevant terms. Unintentional bias may have been introduced into the manuscript by not performing a systematic review of the literature with pre-defined search terms.

Findings and conclusions: While some variation exists in the content of the recommendations, both documents agree on the need for aggressive management of patients with PAD. In spite of these recommendations, there is a general lack of adherence to the current guidelines – a critical concern considering the high morbidity and mortality associated with the disease. However, the results of ongoing clinical trials may serve to increase awareness of the importance of aggressive management of PAD.

Key Words::

• Antiplatelet therapy
• Claudication
• Guidelines
• Peripheral arterial disease

Acknowledgments

Declaration of interest: The authors thank Christopher Radel, PhD and Sheridan Henness, PhD of Wolters Kluwer Health for editorial support in the preparation of the manuscript. This assistance was funded by Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership. The authors did not receive any compensation for this work.