SS2. Congestive Heart Failure with Systolic Dysfunction Is Associated with Decreased Patency after Endovascular Intervention for Symptomatic Peripheral Arterial Disease

Objectives: This study assessed whether the physical component summary score of the RAND-36 health-related quality-of-life survey was associated with incidence of coronary heart disease, stroke, congestive heart failure, angina, or peripheral arterial disease, and whether baseline chronic conditions modified these associations. Methods: Analysis was limited to 69,155 postmenopausal women (50–79 years) in the Women’s Health Initiative Study who had complete data on the RAND-36, the outcomes, and covariates. Chronic conditions were defined as blood pressure ⩾140/90 mm or self-reported heart disease, diabetes, hypertension, arthritis, asthma, emphysema, cancer, and/or cholesterol-reducing medication use. Outcomes data were ascertained during follow-up (1993–2005) with medical records. Results: There were 2451 coronary heart disease, 1896 stroke, 1533 congestive heart failure, 1957 angina, and 502 peripheral arterial disease events during follow-up (median 8.2 years). Participants in the lowest physical component summary quintile, compared to the highest, had a significantly higher risk of developing coronary heart disease (hazard ratio (95% confidence interval) 2.0 (1.7, 2.3)), stroke (1.8 (1.5, 2.2)), angina (2.4(2.0, 2.9)), and peripheral arterial disease (3.0 (2.0, 4.4)), irrespective of chronic conditions. Interactions between physical component summary and existing chronic conditions were not significant for any outcome except congestive heart failure (p = 0.005); after adjustment, participants in the lowest physical component summary quintile and with any chronic condition had nearly a twofold higher risk of congestive heart failure (Yes = 4.4 (3.3, 5.8) vs No = 2.4 (1.2, 4.3)). Conclusion: We found a low physical component summary score was a significant risk factor for individual cardiovascular disease incidence in postmenopausal women.

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Heart failure is associated with reduced patency after endovascular intervention for symptomatic peripheral arterial disease

Journal of Vascular Surgery ◽

10.1016/j.jvs.2011.08.016 ◽

2012 ◽

Vol 55 (2) ◽

pp. 353-362 ◽

Cited By ~ 18

Author(s):

Andrew J. Meltzer ◽

Gautam Shrikhande ◽

Katherine A. Gallagher ◽

Francesco A. Aiello ◽

Sikandar Kahn ◽

...

Keyword(s):

Heart Failure ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Endovascular Intervention ◽

Peripheral Arterial

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Impaired right ventricular filling in patients with a chronic coronary syndrome

Medical Ultrasonography ◽

10.11152/mu-2747 ◽

2021 ◽

Author(s):

Alexey N Sumin ◽

Ekaterina V Korok ◽

Tat'ana Yu Sergeeva

Keyword(s):

Heart Failure ◽

Coronary Artery ◽

Peripheral Arterial Disease ◽

Diastolic Dysfunction ◽

Systolic Dysfunction ◽

Arterial Disease ◽

Left Ventricular ◽

Coronary Syndrome ◽

Stable Cad ◽

Peripheral Arterial

Aim: The prognostic value of right ventricle (RV) systolic dysfunction is known but the RV diastolic dysfunction (RVDD) is less investigated, thus the purpose of this study was to assess the incidence of RVDD in patients with coronary artery disease (CAD) and to identify factors associated with its presence. Material and methods: We examined 200 patients with stable CAD (153 men). RV diastolic parameters were studied by echocardiography: peak velocity of early (Et) and late (At) RV fill-ing and their ratio, velocities at the tricuspid annulus (et’, a’t, s’t). Patients were divided into 2 groups: with (n=92) and without RVDD (n=108). Results: Old myocardial infarction (MI) (p=0.007), anterior MI (p=0.001), congestive heart failure (p=0.030) and peripheral arterial disease (p=0.030) were more prevalent in patients with RVDD. The end-systolic dimensions were higher (p=0.010), while left ventricular (LV) ejection fraction (EF) (p=0.044) and the mitral E/A ratio (p<0.001) were lower in this group. No significant differences were found between the groups in the coronary artery stenosis. Independent predictors of the RVDD presence were increased age, old MI, hyperlipidemia, moderate chronic heart failure, peripheral arterial disease, and decreased LVEF. Conclusions: The RV diastolic dysfunction is much more common than systolic dysfunction in patients with stable CAD (46% and 7.5%, respectively). The RVDD presence was predominantly associated with an increase in age and LV systolic dysfunction, but not with coronary artery lesions. The predictive value of RVDD requires further research.

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The Impact of Peripheral Arterial Disease on Patients with Congestive Heart Failure

Heart Failure Clinics ◽

10.1016/j.hfc.2013.10.006 ◽

2014 ◽

Vol 10 (2) ◽

pp. 327-338 ◽

Cited By ~ 4

Author(s):

Amit N. Keswani ◽

Christopher J. White

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Peripheral Arterial ◽

The Impact

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Burden and Correlates of Hospital Readmissions among U.S. Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2018.00175 ◽

2019 ◽

Vol 39 (3) ◽

pp. 261-267 ◽

Cited By ~ 1

Author(s):

Abyalew Sahlie ◽

Bernard G. Jaar ◽

Lilian Galarza Paez ◽

Tahsin Masud ◽

Janice P. Lea ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Peritoneal Dialysis ◽

Length Of Stay ◽

Peripheral Arterial Disease ◽

Hospital Admissions ◽

Hospital Readmissions ◽

Arterial Disease ◽

Index Admission ◽

Peripheral Arterial

Background Hospital readmissions are common among in- center hemodialysis patients, but little is known about read-missions among peritoneal dialysis (PD) patients. Using national administrative data, we aimed to examine the burden and correlates of hospital readmissions among U.S. PD patients. Methods Among 10,505 adult U.S. PD patients with an index admission (first admission after 120 days on dialysis) between 31 January 2011 and 30 November 2014, readmissions were defined as new hospital admissions within 30 days of index discharge. Multivariable logistic regression was used to obtain adjusted odds ratios (ORs) for readmission. Results Overall, 26.8% of index admissions were followed by a readmission. Readmitted patients were more likely to have congestive heart failure (31.0% vs 25.4%; p < 0.001) and peripheral arterial disease (11.6% vs 8.6%; p < 0.001) and had longer index admission length of stay (median = 4 vs 3 days; p < 0.001) than those who were not; age, sex, and race did not differ by readmission status. After adjustment for patient and index admission characteristics, longer length of stay (≥ 4 vs < 4 days, OR = 1.48, 95% confidence interval [CI] 1.35 – 1.62), peripheral arterial disease (OR = 1.31, 95% CI 1.16 – 1.57), congestive heart failure (OR = 1.25, 95% CI 1.13 – 1.39), and ischemic heart disease (OR = 1.12, 95% CI 1.01 – 1.24) were associated with higher likelihood of readmission; index admission due to peritonitis vs other causes was associated with lower likelihood of readmission (OR = 0.80, 95% CI 0.70 – 0.92). Conclusions Our results suggest that, particularly in the absence of a PD-related cause of hospitalization such as peritonitis, PD patients may be at high risk for readmission and may benefit from closer post-discharge monitoring.

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Physical activity and peripheral arterial disease among patients with coronary artery disease or congestive heart failure

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.01.149 ◽

2016 ◽

Vol 207 ◽

pp. 110-111 ◽

Cited By ~ 1

Author(s):

Paul D. Loprinzi

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Coronary Artery Disease ◽

Congestive Heart Failure ◽

Coronary Artery ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

Artery Disease ◽

Peripheral Arterial

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Impact of Peripheral Arterial Disease on Functional Limitation in Congestive Heart Failure: Results from the National Health and Nutrition Examination Survey (1999–2004)

Cardiology Research and Practice ◽

10.1155/2012/306852 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Bamidele A. Adesunloye ◽

Ravinder Valadri ◽

Nkechi M. Mbaezue ◽

Anekwe E. Onwuanyi

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Peripheral Arterial Disease ◽

Functional Limitation ◽

Arterial Disease ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

Independent Association ◽

Peripheral Arterial ◽

Weighted Prevalence

Background. Peripheral arterial disease (PAD) often coexists with congestive heart failure (CHF) and can be masked by symptoms of CHF such as functional limitation (FL), a common manifestation for both. Therefore, we sought to estimate the prevalence of PAD and its independent association with FL in CHF.Methods.We conducted a cross-sectional study on National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 to quantify weighted prevalence of CHF and PAD. Study cohort consisted of 7513, with ankle brachial index (ABI) measurements at baseline. Independent association of PAD (ABI ≤ 0.9) with FL in CHF was determined with multivariate logistic regression (MVLR).Results.Overall weighted PAD prevalence was 5.2%. CHF was present in 305 participants, and the weighted prevalence of PAD in this subgroup was 19.2%. When compared, participants with CHF and PAD were more likely to be older (P<0.001), hypertensive (P=0.005) and hypercholesterolemic (P=0.013) than participants with CHF alone. MVLR showed that PAD (adjusted OR = 5.15; 95% CI: 2.2, 12.05:P<0.05) and arthritis (adjusted OR = 2.36; 95% CI: 1.10, 5.06: P<0.05) were independently associated with FL in CHF.Conclusion.Independent association of PAD with FL suggests the need for reinforced screening for PAD in individuals with CHF.

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P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

British Journal of Surgery ◽

10.1093/bjs/znab117.091 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

MI Qureshi ◽

HL Li ◽

GK Ambler ◽

KHF Wong ◽

S Dawson ◽

...

Keyword(s):

Systematic Review ◽

Peripheral Arterial Disease ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Arterial Intervention ◽

Arterial Disease ◽

Endovascular Intervention ◽

Randomised Trials ◽

Peripheral Arterial ◽

High Level

Abstract Introduction Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention. Method This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention. Result Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified. Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies. Conclusion Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies. Take-home message To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

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