{"id":{"repo_id":"umkc","oai_identifier":"oai:mospace.umsystem.edu:10355/68865"},"canonical_url":"https://search.dev.ndltd.org/etd/umkc/oai:mospace.umsystem.edu:10355/68865","repository":{"repo_id":"umkc","name":"University of Missouri - Kansas City","base_url":"https://mospace.umsystem.edu/oai/request"},"display":{"title":"Guideline-Directed Statin Therapy in Patients with New or Worsening Symptoms of Peripheral Artery Disease","abstract":"Objective: The ACC/AHA cholesterol guidelines recommend patients with peripheral artery disease (PAD) be treated with a moderate to high-intensity statin. The extent to which PAD patients with new or worsening claudication symptoms are offered guideline statin therapy is unknown. Methods: In the PORTRAIT registry, patterns of statin therapy were assessed in 1144 patients at 16 PAD specialty clinics (between June 2011-December 2015) before and after an evaluation for new or worsening claudication symptoms. It was documented whether patients had been previously treated with a guideline-directed statin as well as switched from non guideline to guideline statin therapy. Patient factors predicting intensification to guideline statin were examined. Site and provider-level variation in guideline statin intensification were summarized by calculating median odds ratios. Results: Among 1144 patients, 810 (70.8%) were initially on guideline therapy compared with 334 (29.2%) that were not. In the latter, 103 (30.8%) were prescribed guideline therapy after evaluation. Patients with typical symptoms displayed greater odds of intensification to guideline statin (OR 3.75; 95% CI: 1.22-11.53) while older patients had lower odds (OR 0.60/decade; 95% CI: 0.40-0.87). Variability in guideline statin intensification was observed across sites (Adjusted Median Odds Ratio = 3.63; 95% CI 1.88-5.42, (p <0.05)) but not providers (Adjusted Median Odds Ratio = 1.90; 95% CI 1.00-2.55, (p >0.05)). Conclusions: In conclusion, most patients evaluated at a PAD specialty clinic for new or worsening claudication symptoms arrived on a guideline-directed statin. Only 31% originally off guideline therapy were intensified to a guideline statin. These findings highlight an important opportunity to optimize medical therapy for patients with PAD.","abstract_html":"Objective: The ACC/AHA cholesterol guidelines recommend patients with peripheral artery disease (PAD) be treated with a moderate to high-intensity statin. The extent to which PAD patients with new or worsening claudication symptoms are offered guideline statin therapy is unknown. Methods: In the PORTRAIT registry, patterns of statin therapy were assessed in 1144 patients at 16 PAD specialty clinics (between June 2011-December 2015) before and after an evaluation for new or worsening claudication symptoms. It was documented whether patients had been previously treated with a guideline-directed statin as well as switched from non guideline to guideline statin therapy. Patient factors predicting intensification to guideline statin were examined. Site and provider-level variation in guideline statin intensification were summarized by calculating median odds ratios. Results: Among 1144 patients, 810 (70.8%) were initially on guideline therapy compared with 334 (29.2%) that were not. In the latter, 103 (30.8%) were prescribed guideline therapy after evaluation. Patients with typical symptoms displayed greater odds of intensification to guideline statin (OR 3.75; 95% CI: 1.22-11.53) while older patients had lower odds (OR 0.60/decade; 95% CI: 0.40-0.87). Variability in guideline statin intensification was observed across sites (Adjusted Median Odds Ratio = 3.63; 95% CI 1.88-5.42, (p &lt;0.05)) but not providers (Adjusted Median Odds Ratio = 1.90; 95% CI 1.00-2.55, (p &gt;0.05)). Conclusions: In conclusion, most patients evaluated at a PAD specialty clinic for new or worsening claudication symptoms arrived on a guideline-directed statin. Only 31% originally off guideline therapy were intensified to a guideline statin. These findings highlight an important opportunity to optimize medical therapy for patients with PAD.","abstract_has_math":false,"creators":["Khariton, Yevgeniy"],"institution":"University of Missouri -- Kansas City","degree_name":"M.S. (Master of Science)","degree_level":"Masters","degree_discipline":"Bioinformatics (UMKC)","degree_department":null,"school":null,"contributors":[],"advisors":["Smolderen, Kim G."],"committee_chairs":[],"committee_members":[],"year":2018,"date_issued":"2018","date_published":"2018","updated_at":"2026-07-24T05:19:15Z","subjects":[],"languages":["en_US"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/10355/68865","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Smolderen, Kim G."]},{"key":"dc:creator","label":"Author","values":["Khariton, Yevgeniy"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2019-06-05T14:11:18Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2019-06-05T14:11:18Z"]},{"key":"dc:date.issued","label":"Date","values":["2018"]},{"key":"dc:publisher","label":"Institution","values":["University of Missouri -- Kansas City"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Bioinformatics (UMKC)"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Masters"]},{"key":"thesis:degree_name","label":"Degree Name","values":["M.S. (Master of Science)"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["University of Missouri--Kansas City"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en_US"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/10355/68865"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Title from PDF of title page viewed June 14, 2019","Thesis advisor: Kim Smolderen","Vita","Includes bibliographical references (pages 39-46)","Thesis (M.S.)--School of Medicine. University of Missouri--Kansas City, 2018"]},{"key":"dc:description.abstract","label":"Abstract","values":["Objective: The ACC/AHA cholesterol guidelines recommend patients with peripheral artery disease (PAD) be treated with a moderate to high-intensity statin. The extent to which PAD patients with new or worsening claudication symptoms are offered guideline statin therapy is unknown. Methods: In the PORTRAIT registry, patterns of statin therapy were assessed in 1144 patients at 16 PAD specialty clinics (between June 2011-December 2015) before and after an evaluation for new or worsening claudication symptoms. It was documented whether patients had been previously treated with a guideline-directed statin as well as switched from non guideline to guideline statin therapy. Patient factors predicting intensification to guideline statin were examined. Site and provider-level variation in guideline statin intensification were summarized by calculating median odds ratios. Results: Among 1144 patients, 810 (70.8%) were initially on guideline therapy compared with 334 (29.2%) that were not. In the latter, 103 (30.8%) were prescribed guideline therapy after evaluation. Patients with typical symptoms displayed greater odds of intensification to guideline statin (OR 3.75; 95% CI: 1.22-11.53) while older patients had lower odds (OR 0.60/decade; 95% CI: 0.40-0.87). Variability in guideline statin intensification was observed across sites (Adjusted Median Odds Ratio = 3.63; 95% CI 1.88-5.42, (p <0.05)) but not providers (Adjusted Median Odds Ratio = 1.90; 95% CI 1.00-2.55, (p >0.05)). Conclusions: In conclusion, most patients evaluated at a PAD specialty clinic for new or worsening claudication symptoms arrived on a guideline-directed statin. Only 31% originally off guideline therapy were intensified to a guideline statin. These findings highlight an important opportunity to optimize medical therapy for patients with PAD."]},{"key":"dc:title","label":"Title","values":["Guideline-Directed Statin Therapy in Patients with New or Worsening Symptoms of Peripheral Artery Disease"]}]}],"canonical_facts":{"dc:contributor.advisor":["Smolderen, Kim G."],"dc:creator":["Khariton, Yevgeniy"],"dc:date.accessioned":["2019-06-05T14:11:18Z"],"dc:date.available":["2019-06-05T14:11:18Z"],"dc:date.issued":["2018"],"dc:description":["Title from PDF of title page viewed June 14, 2019","Thesis advisor: Kim Smolderen","Vita","Includes bibliographical references (pages 39-46)","Thesis (M.S.)--School of Medicine. University of Missouri--Kansas City, 2018"],"dc:description.abstract":["Objective: The ACC/AHA cholesterol guidelines recommend patients with peripheral artery disease (PAD) be treated with a moderate to high-intensity statin. The extent to which PAD patients with new or worsening claudication symptoms are offered guideline statin therapy is unknown. Methods: In the PORTRAIT registry, patterns of statin therapy were assessed in 1144 patients at 16 PAD specialty clinics (between June 2011-December 2015) before and after an evaluation for new or worsening claudication symptoms. It was documented whether patients had been previously treated with a guideline-directed statin as well as switched from non guideline to guideline statin therapy. Patient factors predicting intensification to guideline statin were examined. Site and provider-level variation in guideline statin intensification were summarized by calculating median odds ratios. Results: Among 1144 patients, 810 (70.8%) were initially on guideline therapy compared with 334 (29.2%) that were not. In the latter, 103 (30.8%) were prescribed guideline therapy after evaluation. Patients with typical symptoms displayed greater odds of intensification to guideline statin (OR 3.75; 95% CI: 1.22-11.53) while older patients had lower odds (OR 0.60/decade; 95% CI: 0.40-0.87). Variability in guideline statin intensification was observed across sites (Adjusted Median Odds Ratio = 3.63; 95% CI 1.88-5.42, (p <0.05)) but not providers (Adjusted Median Odds Ratio = 1.90; 95% CI 1.00-2.55, (p >0.05)). Conclusions: In conclusion, most patients evaluated at a PAD specialty clinic for new or worsening claudication symptoms arrived on a guideline-directed statin. Only 31% originally off guideline therapy were intensified to a guideline statin. These findings highlight an important opportunity to optimize medical therapy for patients with PAD."],"dc:identifier.uri":["https://hdl.handle.net/10355/68865"],"dc:language.iso":["en_US"],"dc:publisher":["University of Missouri -- Kansas City"],"dc:title":["Guideline-Directed Statin Therapy in Patients with New or Worsening Symptoms of Peripheral Artery Disease"],"dc:type":["Thesis"],"thesis:degree_discipline":["Bioinformatics (UMKC)"],"thesis:degree_level":["Masters"],"thesis:degree_name":["M.S. (Master of Science)"],"thesis:institution_name":["University of Missouri--Kansas City"]},"updated_at":"2026-07-24T05:19:15Z"}