The 2024 AHA/ACC Guideline on the Management of Lower Extremity Peripheral Artery Disease has been officially released today. This new guideline serves as an update to the previous “2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease,” incorporating the latest evidence to assist clinicians in providing comprehensive care for patients with peripheral artery disease (PAD).

Today, we will explore the changes that have been made in the 2024 PAD Guideline and highlight some key points to take away from it. Before we dive in, the AHA/ACC Peripheral Artery Disease Lower Extremity Guidelines Pocket Guide is now available online and, in the Guideline Central mobile apps. You can access that here.

Significant advancements have been made in medical therapies over the past 8 years since the release of the previous PAD Guidelines. Today we’ll take a look at what’s changed, as well as some key takeaways. Please note, this list doesn’t represent ALL of the changes to the guidelines. It is meant to highlight some of the changes. To see a full list/comparison of the new recommendations, make sure to check out the full text guideline or the pocket guide in the links above. Now, let us begin our exploration of the new guidelines!

PAD Guidelines Key Changes and Takeaways Comparing 2024 vs 2016

Addition of information on health disparities

  • The 2024 PAD guideline recognizes the intricate relationship between PAD and health disparities. In the previous guideline, health disparities and their impact on diagnosis, treatment, and patient outcomes were not examined.

Addition and changes to effective medical therapies for patients with PAD

  • In patients with asymptomatic PAD, single antiplatelet therapy is reasonable to reduce the risk of major adverse cardiovascular events (MACE).
  • In patients with symptomatic PAD, low-dose rivaroxaban (2.5 mg twice daily) combined with low-dose aspirin is effective to reduce the risk of MACE and MALE.
  • After endovascular or surgical revascularization for PAD, low-dose rivaroxaban (2.5 mg twice daily) combined with low-dose aspirin is recommended to reduce the risk of MACE and MALE.
  • After endovascular or surgical revascularization in patients with PAD who require full-intensity anticoagulation for another indication and are not at high risk of bleeding, adding single antiplatelet therapy is reasonable.
  • After surgical revascularization for PAD with a prosthetic graft, dual antiplatelet therapy with a P2Y12 antagonist and low-dose aspirin may be reasonable for at least 1 month.
  • In patients with PAD who are on maximally tolerated statin therapy who have an LDL-C level of ≥70 mg/dL, it is reasonable to add PCSK9 inhibitor therapy.
  • In patients with PAD who are on maximally tolerated statin therapy and have an LDL-C level of ≥70 mg/dL, it is reasonable to add ezetimibe therapy.

There you have it – a rundown of some of the bigger Peripheral Artery Disease Lower Extremity Guidelines key changes and takeaways. We’ll have more exciting guideline updates to share in the coming days/weeks. Sign up for alerts and stay informed on the latest published guidelines and articles.

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