scholarly journals Lipid-lowering and anti-thrombotic therapy in patients with peripheral arterial disease

Author(s):  
Jill J.F. Belch ◽  
Marianne Brodmann ◽  
Iris Baumgartner ◽  
Christoph J. Binder ◽  
Manuela Casula ◽  
...  
1997 ◽  
Vol 2 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Alan T Hirsch ◽  
Diane Treat-Jacobson ◽  
Harry A Lando ◽  
Dorothy K Hatsukami

Despite the widely held belief that there are no effective medical therapies for peripheral arterial disease (PAD), current data suggest that medical therapies can effectively modify the natural history of atherosclerotic lower extremity arterial occlusive disease. The ideal medical therapy would improve claudication, forestall the onset of limb-threatening events, decrease rates of invasive interventional therapies and improve long-term patient survival. These ideal outcomes might be achieved through the use of smoking cessation interventions, including behavioral and pharmacological therapy, and the administration of antiplatelet and lipid-lowering medications in patients with PAD.


2005 ◽  
Vol 80 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Daniel G. Federman ◽  
Dana C. Ranani ◽  
Robert S. Kirsner ◽  
Dawn M. Bravata

2005 ◽  
Vol 10 (2) ◽  
pp. 145-147 ◽  
Author(s):  
Stella S. Daskalopoulou ◽  
Vasilios G. Athyros ◽  
George Hamilton ◽  
Dimitri P. Mikhailidis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.V Vitalis ◽  
A.S Shantsila ◽  
R.T Thayakaran ◽  
K.N Nirantharakumar ◽  
G.Y.L Lip

Abstract   Atrial fibrillation in a cohort of patients with peripheral arterial disease. A retrospective study of a healthcare database in UK. Background There is strong evidence that peripheral arterial disease (PAD) is linked with worse outcomes in patients with atrial fibrillation (AF), which has led vascular disease to be included as one of the components of CHA2DS2-VASc score for risk stratification in AF. On the other hand, very limited evidence exists on the prognostic implication of AF in patients with PAD. Purpose The aim of this study is to identify the prevalence of AF in a cohort of PAD patients and demonstrate its association with adverse cardiovascular outcomes, limb loss and mortality. Methods This is a retrospective study of The Health Improvement Network (THIN) database, which contains computerized records from primary care physicians, covering more than 11 million patients from over 600 general practices in the UK. During the studied period from 1995 to 2017, 55540 patients with newly diagnosed PAD have been detected in the database and baseline characteristics, coexisting medical diagnoses (including AF), relevant medication and subsequent outcomes have been recorded using appropriately selected clinical codes (READ codes). A comparison of baseline characteristics was made between patients with PAD and AF and those without AF using descriptive statistics. Multivariate cox regression analysis was then performed and hazard rations for mortality, stroke or transient ischaemic attack (TIA), ischaemic heart disease (IHD), heart failure (HF) and major lower limb amputation at presence of AF were calculated, after adjustment for age, sex, ethnicity, BMI, smoking, Townsend comorbidity index, diabetes, hypertension, kidney function, and medication (lipid- lowering, antiplatelets, anticoagulants). Results From the 55540 patients with new diagnosis of PAD during the study period, 5685 (10.2%) had coexisting AF. Patients with AF were older, had higher prevalence of diabetes, hypertension and renal failure, were more likely to be on anticoagulants, antiplatelets and lipid lowering agents, were more likely to be ex-smokers but less likely to be active smokers. Mean follow up period was 5.1 (SD= 4) years. After adjustment for confounders, AF patients were at higher risk for death (HR: 1.30, 95% CI 1.24- 1.37, p<0.01) for stroke or TIA (HR: 1.46, 95% CI 1.29- 1.65, p<0.01) and for HF (HR: 1.85, 95% CI 1.65- 2.08, p<0.01). There was no significant association between AF and development of IHD (p=0.34) and limb loss (p=0.14) in this cohort. Conclusion AF is a predictor of worse prognosis in patients with PAD. Close monitoring and medical optimization of these patients is warranted. Funding Acknowledgement Type of funding source: None


2018 ◽  
Vol 23 (46) ◽  
pp. 7099-7108 ◽  
Author(s):  
Scott T. Chiesa ◽  
Nikos Papageorgiou ◽  
Marietta Charakida

Peripheral arterial disease (PAD) is a common atherosclertico condition affecting the lower extremities. PAD patients share similar cardiovascular risk factors to coronary artery disease patients and suffer from increased cardiovascular morbidity and mortality. Statins have been widely used in coronary artery disease patients but have been underused in patients with PAD. In the current review, we present data which support the beneficial role of statins in both reducing cardiovascular events and improving symptom-related outcomes in PAD patients. Alongside their lipid lowering effects, their pleiotropic actions are also discussed. Recent guidelines, which strongly recommend the administration of statins in PAD patients, are also presented.


Angiology ◽  
2008 ◽  
Vol 60 (4) ◽  
pp. 462-467 ◽  
Author(s):  
Robin Joyce Barrows ◽  
Ulrike Krumsdorf ◽  
Alexandra Zankl ◽  
Hugo Katus ◽  
Christiane Pia Tiefenbacher

Background. Peripheral arterial disease (PAD) indicates generalized atherosclerosis but is still underdiagnosed and undertreated. Methods. Data were collected from patients with PAD from the Department of Cardiology and Angiology, University of Heidelberg, Germany. The prevalence of cardiovascular risk factors and medication were documented. Results. Atherogenic risk factors, cardiovascular disease, and cerebrovascular disease were highly prevalent. By continuous care at the university clinic, in addition to family medicine treatment, the use of platelet inhibitors, antihypertensives, and lipid-lowering therapy was increased. Ankle—brachial index and walking distance improved. Conclusion. Long-term treatment at the university clinic had positive effects on atherogenic risk factors. The regular use of secondary preventive medication was improved. Still, this patient population remained undertreated and showed a high incidence of vascular event rates and a need for vascular interventions. This study implies the importance of both specialists and general practitioners in the care of these individuals.


Author(s):  
Phyu Phyu Aung ◽  
Heather Maxwell ◽  
Ruth G Jepson ◽  
Jackie Price ◽  
Gillian C Leng

2007 ◽  
Vol 45 (5) ◽  
pp. 936-943 ◽  
Author(s):  
Harm H.H. Feringa ◽  
Stefanos E. Karagiannis ◽  
Virginie H. van Waning ◽  
Eric Boersma ◽  
Olaf Schouten ◽  
...  

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