Clin Res Cardiol (2021)
DOI DOI https://doi.org/10.1007/s00392-021-01843-w
Prevalence, specialized ambulatory care and underuse of guideline-recommended therapy in patients with lower-extremity artery disease in Germany; 2009-2018
O. Petrikhovich1, A.-A. Mahabadi1, M. Steinmetz1, J. Lortz1, R. Hering2, M. Schulz2, T. Rassaf1, C. Rammos1
1Klinik für Kardiologie und Angiologie, Universitätsklinikum Essen, Essen; 2Zentralinstitut für die kassenärztliche Versorgung in Deutschland, Berlin;

Background Patients with lower-extremity artery disease (LEAD) are defined by high morbidity and mortality, resulting in a need for optimal medical treatment strategies. While undertreatment and underuse of medications is suspected, exact knowledge of prevalence, treatment structures and contact with dedicated specialists including prescription of guideline-recommended pharmacotherapy is lacking. We present population-level data on changes in trends regarding prevalence and treatment patterns of LEAD from 2009 to 2018 in Germany.

Methods and Results We analysed ambulatory claims and drug prescription data of all statutory insured patients in Germany comprising 70.1 million patients/ year. Prevalence of LEAD was stratified by age and gender with a timeframe of 10 years showing an increased prevalence from 1.85% in 2009 to 3.14% in 2018, affecting more males (55%) than females (45%). In addition, current ambulatory care was examined subdivided by vascular specialist (vascular surgeons or angiologists) and primary care physicians showing a low access to vascular specialist with 11.1% of patients receiving care from vascular surgeons and 8.1% from angiologists. The prescription of guideline-recommended statin therapy and antiplatelet inhibition was analysed for 2009-2016 demonstrating increased while still insufficient prescription frequencies with 42.6% in 2009 to 56% in 2016 for statins and 40.2% to 48.0% for antiplatelets, respectively.

Conclusion Prevalence of LEAD in Germany is rapidly increasing and LEAD patients are in need for specialized vascular care, while use of guideline-recommended prescriptions remains alarmingly low. There is a clear need to improve the treatment algorithms in the high-risk LEAD population.

https://dgk.org/kongress_programme/jt2021/aP1606.html