Pharmaceutical initiatives to combat atherosclerosis--what to do with the good, the bad, and the ugly lipoproteins

Abstract

The patient with peripheral arterial disease (PAD) poses a special problem. Not only are vascular surgeons interested in preventing the limb complications of PAD, but also the associated cardiac and neurological events that contribute greatly to the overall morbidity and mortality of their patients. Therefore, the control of atherosclerotic risk factors must be considered as important a therapeutic goal as surgical and endovascular control of limb ischemia. To accomplish this, the "complete" vascular surgeon must understand the common lipid abnormalities, their diagnosis, and treatment. The scientific literature on this subject is truly overwhelming in volume and scope, yet an overly simple "cook book" approach is not adequate or appropriate. This report summarizes current knowledge on this topic, providing sufficient essential detail for the reader to understand why, when, and how to administer which lipid-controlling agents to patients with PAD.