Questioning Medicine

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001251. Diagnosis:To establish a PAD diagnosis, the resting ankle–brachial index (ABI) remains the initial test of choice in patients with suggestive history or exam findings. The ABI result should be reported as normal (1–1.4), borderline (0.91–0.99), abnormal (≤0.9) or noncompressible (>1.4). TREATMET Low-dose rivaroxaban 2.5mg BID, in addition to daily aspirin, is now recommended to decrease the risk for major adverse cardiovascular events (MACEs) and major adverse limb events in patients with symptomatic PAD who are not at increased bleeding risk. This is based on the COMPASS trial Cardiovascular Outcomes for People Using Anticoagulation Strategies - American College of Cardiology (acc.org) and as a reminder inclusion criteria was “Atherosclerosis in ≥2 vascular beds or two additional risk factors (current smoking, diabetes, renal insufficiency, heart failure, or nonlacunar ischemic stroke ≥1 month)” In pts with symptomatic PAD—single antiplatelet w