Lower extremities peripheral arterial disease among patients admitted to cardiac rehabilitation: The THINKPAD registry

Marco Ambrosetti, Pier Luigi Temporelli, Pompilio Faggiano, Oreste Febo, Tommaso Diaco, Giuseppe Favretto, Pasqualina Calisi, Michele Gabriele, Cesare Greco, Luigi Tavazzi

Research output: Contribution to journalArticlepeer-review


Background/objectives Lower extremities peripheral arterial disease (LE-PAD) across the wide range of conditions for Cardiac Rehabilitation (CR) is poorly understood. The "ATHerosclerosis of the lower extremIties as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation" (THINKPAD) registry explored LE-PAD in CR patients in terms of prevalence and interventions delivered. Methods Multicenter, consecutive case series of 1506 patients discharged from 16 CR Units in Italy from May 1 to June 30, 2012. Results LE-PAD constituted a primary indication for CR and a comorbidity on admission in 2.6% and 9.3% of patients respectively. LE-PAD patients were significantly older (72 ± 9 vs. 67 ± 12 years, p <0.001) and displayed a worse cardiovascular risk profile (diabetes 38% vs. 23%, hypertension 86% vs. 63%, hypercholesterolemia 74% vs. 52%, smoking 72% vs. 50%, low level of physical activity 84% vs. 69%, impaired diet habits 69% vs. 55%, p <0.01 for all). COPD (17% vs. 11%, p <0.05), CKD (20% vs. 10%, p <0.01), and past history of coronary revascularization (29% vs. 14%, p <0.001) were also more represented in the LE-PAD group. Half of LE-PAD patients received a formal staging, with low provision of ABI (18%) and color Doppler (48%) investigation. Secondary prevention targets at the end of CR for blood pressure and lipid control were accomplished in 83% and 46% of patients respectively (strongly correlated with the presence of CAD), while other guideline-recommended drugs for LE-PAD were prescribed in less than 4% of cases. Conclusion LE-PAD represents an uncommon referral indication for CR. Our data confirm its systematic underassessment and undertreatment.

Original languageEnglish
Pages (from-to)192-198
Number of pages7
JournalInternational Journal of Cardiology
Issue number2
Publication statusPublished - Feb 1 2014


  • Cardiac rehabilitation
  • Epidemiology
  • Peripheral arterial disease
  • Secondary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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