Medical therapy following urgent/emergent revascularization in Peripheral artery disease patients (CANAdian Limb Ischemia rEgistry (CANALISE I)

Abstract BACKGROUND Following severe limb ischemia requiring urgent/emergent revascularization, peripheral arterial disease (PAD) patients suffer a high risk of recurrent atherothrombosis. METHODS Patients discharged from Hamilton General Hospital between April 2016 and September 2017 following severe limb ischemia requiring urgent/emergent revascularization were identified via the Local Health Integration Network CorHealth database and supplemented with information from chart review. RESULTS 158 patients admitted for urgent/emergent revascularization were identified (148 alive at discharge). Among patients without a pre-existing indication for anticoagulation, 38.8% (n=47) were discharged on single antiplatelet therapy (SAPT), 27.3% (n=33) on dual antiplatelet therapy (DAPT), 19.8% (n=24) on anticoagulants (AC) plus antiplatelet therapy, 6.6% (n=8) on AC alone, and 2.6% (n=3) on unknown therapy. Patients who received angioplasty with stenting were more likely be discharged on DAPT (HR: 7.14; 95% CI: (2.87-17.76);p CONCLUSION Substantial heterogeneity in antithrombotic prescription exists following urgent/emergent revascularization. No intensification of non-antithrombotic vascular protective medications occurred during hospitalization. Clinical trials and health system interventions to optimize medical therapy in PAD patients are urgently needed.