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Similar MACE rates but higher all-cause mortality in PAD patients with diabetes

Conference
ACC 2019
Trial
EXSCEL

Results from the EXSCEL trial suggest that peripheral artery disease (PAD) patients were less likely to be on optimal medical therapy for secondary prevention of cardiovascular (CV) disease, specifically statins, beta-blockers, ACE inhibitors, and aspirin [1]. Although large studies in patients with diabetes have identified agents that lower major adverse cardiovascular event (MACE) rates, certain agents increase rates of lower extremity amputation (LEA). Especially patients with peripheral artery disease run a risk, as they have a greater incidence of diabetes and risk for lower extremity amputation.

The EXSCEL study tested the effects of the GLP-1 agonist exenatide vs placebo on the rates of the primary composite MACE endpoint (i.e. CV death, myocardial infarction, or stroke) and a post-hoc analysis assessed the association of PAD with rates of MACE, LEA, and the effects of exenatide vs placebo in patients with and without PAD. The 2,800 enrolled PAD pat...



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