Cost of atherothrombotic diseases—myocardial infarction, ischaemic stroke and peripheral arterial occlusive disease—in Germany

2005 ◽  
Vol 13 (4) ◽  
pp. 216-224 ◽  
Author(s):  
B. Brüggenjürgen ◽  
H.-J. Rupprecht ◽  
S. N. Willich ◽  
M. Spannagl ◽  
B. Ehlken ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ischaemic Stroke ◽  
Peripheral Arterial Occlusive Disease ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Peripheral Arterial

Progressive Peripheral Arterial Occlusive Disease and Other Vascular Events During Nilotinib Therapy in Chronic Myeloid Leukemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1679-1679 ◽  
Author(s):  
Luciano Levato ◽  
Renato Cantaffa ◽  
Mariagrazia Kropp ◽  
Domenico Magro ◽  
Eugenio Piro ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Myeloid Leukemia ◽  
Peripheral Arterial Occlusive Disease ◽  
Myeloid Leukemia ◽  
Second Generation ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Line Treatment ◽  
Second Line ◽  
Peripheral Arterial

Abstract Abstract 1679 Recent data suggest that second-generation tyrosine-kinase inhibitor (TKI) dasatinib and nilotinib can be responsible for increased non-hematologic adverse events in comparison to imatinib. In particular, there are a few reports of severe peripheral arterial occlusive disease (PAOD) and other vascular occlusive events (infarction) in patients receiving nilotinib. With this in mind we retrospectively evaluated incidence of PAOD or other vascular occlusive events in our cohort including 82 consecutive chronic myeloid leukemia (CML) patients treated at our institution with imatinib alone (n=55) or nilotinib as first-line (n=17) or second-line treatment after imatinib failure (n=10). After a median time of exposition to nilotinib of 24 months (range, 7–34 months) 4 (14.8%) out of 27 patients developed an episode of severe and previously unrecognized PAOD or other vascular occlusive events (2 PAOD, 1 myocardial infarction, 1 ictus). All 4 patients were more than 60 years old and 3 out of 4 were male while obesity was never observed. A history of nicotine abuse could be found in 2 out of 4 patients. The same applied when we looking for the presence of arterial hypertension (2/4) or dyslipidemia (2/4). When 55 patients treated with imatinib were analyzed for PAOD or other vascular occlusive event incidence we detected only one patient who experienced myocardial infarction after 135 months of therapy. We then evaluated the likelihood of developing PAOD in the subset of patients treated only with imatinib and in those who received nilotinib, respectively. The projected 10-year actuarial probability of remaining PAOD-free was 100% in the imatinib group and 67% in the nilotinib group (HR, 14.6; P=0.0008). Interestingly, the two patient cohorts were alike with respect to age (P=0.76), gender (P=0.80), number cardiovascular risk factors (P=0.62) and body mass index (P=0.59). The only difference we observed was a significantly longer exposition to drug among patients treated only with imatinib in comparison to those who received nilotinib (P<0.001). In conclusion this study although hampered by the relatively small patient number suggests that in CML front-line and second-line treatment should be adapted to the individual situation in each patient. Parameters related to risk of developing TKI-associated adverse PAOD events should be considered before choosing a second-generation TKI. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Association of Periodontitis and Peripheral Arterial Occlusive Disease in a Prospective Population-Based Cross-Sectional Cohort Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2048
Author(s):  
Nicole Jacobi ◽  
Carolin Walther ◽  
Katrin Borof ◽  
Guido Heydecke ◽  
Udo Seedorf ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Occlusive Disease ◽  
Ankle Brachial Index ◽  
Population Based ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Health Study ◽  
Cross Sectional ◽  
Severe Periodontitis ◽  
Peripheral Arterial

Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study. Design: This population-based cross-sectional cohort study included data from 3271 participants aged between 45 and 74 years enrolled in the Hamburg City Health Study (NCT03934957). Material & Methods: An ankle-brachial-index below 0.9, color-coded ultrasound of the lower extremity arteries, and survey data was used to identify participants with either asymptomatic or symptomatic PAOD. Periodontitis data was collected at six sites per tooth and included the probing depth, gingival recession, clinical attachment loss, and bleeding on probing index. Multivariate analyses using logistic regression models were adjusted for variables including age, sex, smoking, education, diabetes, and hypertension. Results: The baseline characteristics differed widely between participants neither affected by periodontitis nor PAOD vs. the group where both PAOD and severe periodontitis were identified. A higher rate of males, higher age, lower education level, smoking, diabetes, and cardiovascular disease was observed in the group affected by both diseases. After adjusting, presence of severe periodontitis (odds ratio 1.265; 97.5% CI 1.006–1.591; p = 0.045) was independently associated with PAOD. Conclusion: In this cross-sectional analysis of a prospective cohort study, an independent association between periodontitis and PAOD was revealed. The results of the current study emphasize a potential for preventive medicine in an extremely sensitive target population. Future studies should determine the underlying factors modifying the relationship between both diseases.

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