Persistent gaps in treatment practice remain for peripheral artery disease (PAD) and atherosclerosis. Megan Lee, a fourth-year medical student at the Yale School of Medicine, explores inconsistencies in the use of guideline-directed medical therapy following peripheral vascular intervention (PVI), a minimally invasive procedure that restores blood flow to the lower limbs.
Published in the American Heart Journal, the study analyzes site variability in antithrombotic prescription rates using data from the Vascular Quality Initiative between October 1, 2016 and December 31, 2019. The findings demonstrate the variability between sites of antithrombotic medications before and following a peripheral vascular intervention.
Lee, who completed a research internship with the Vascular Medicine Outcomes program, found that half of patients undergoing peripheral vascular interventions received single antiplatelet therapy or SAPT before PVI. The data included 72,582 total PVI cases from 328 centers. The largest increase was for dual antiplatelet therapy or DAPT, which rose from 27 to 58 percent at discharge. A small percentage of patients did not receive any medical therapy.
The study suggests that further research is needed to understand the high variability in prescription rates. The senior authors, Carlos Mena, MD, and Kim Smolderen, PhD, concluded that educational interventions based on the current clinical evidence may help physicians determine the optimal medical therapy following PVI.
Lee presented at the ACC’s 70th Annual Scientific Session in Atlanta, GA earlier this year.
Dr. Mena and Dr. Smolderen have been instrumental in helping me discover my passion for incorporating research into my future career. They have exemplified the curiosity to take questions from clinical experiences and combine it with their expertise in research to create real solutions for patients.
Megan Lee
“Dr. Mena and Dr. Smolderen have been instrumental in helping me discover my passion for incorporating research into my future career. They have exemplified the curiosity to take questions from clinical experiences and combine it with their expertise in research to create real solutions for patients. Their perseverance in the face of setbacks, dedication to quality, and faith in our work have inspired me as a student and researcher,” said Lee.
“I have learned so much from this work, and the knowledge of the process of carrying an analysis to publication will be translated to future projects. I hope to continue building upon the skills I acquired as well as the spirit of teamwork to continue the pursuit of research in my last year of medical school and in my career as a physician,” she added.
After she graduates, Lee will pursue a career as an academic psychiatrist with a research interest in the intersection of pain and addiction.
“Mental health within cardiovascular disease is critical to study, especially for patients with peripheral artery disease, and I would love to continue defining problems and creating solutions to help patients improve their quality of life,” she said.