LOW SERUM EICOSAPENTAENOIC ACID–ARACHIDONIC ACID RATIO INDICATES FOLLOWING CARDIOVASCULAR AND LIMB–ISCHEMIC EVENTS IN PATIENTS WITH PERIPHERAL ARTERY DISEASE

Background: The eicosapentaenoic acid to arachidonic acid ratio (EPA/AA) is attracting attention as a risk factor for peripheral artery disease (PAD). However, there have been few studies investigating the relationship between the EPA/AA ratio and atherosclerotic risk factors in patients with PAD. The purpose of the present study was to analyze atherosclerotic risk factors in patients with PAD to identify those factors associated with a low EPA/AA ratio. Methods. The data of patients treated for symptomatic PAD at Tokyo Medical University Hospital and Eniwa Midorino Clinic between April 2014 and March 2018 were retrospectively analyzed. Results. A total of 149 patients were tested for blood levels of n-3 and n-6 polyunsaturated fatty acids, including EPA and AA. 73 patients had a low EPA/AA ratio (<0.4) and 76 patients had a high EPA/AA ratio (≥ 0.4). Univariate analysis showed that older age (≥ 75 years), female sex, smoking history, body mass index (BMI), and hemoglobin A1C (HbA1C) were associated with the low EPA/AA ratio. Multivariable analysis showed that older age (odds ratio [OR], 0.34; 95% confidential interval [CI], 0.15-0.76; p = 0.008), BMI (OR, 0.87; 95% CI, 0.77-0.98; p = 0.027), smoking history (OR, 2.67; 95% CI, 1.09-6.55; p = 0.007), and HbA1C (OR, 0.46; 95% CI, 0.29-0.72; p = 0.020) were independently associated with the low EPA/AA ratio. Conclusions. The EPA/AA ratio was related to existing arteriosclerotic risk factors in patients with PAD; it was positively correlated with older age, increasing BMI, and higher HbA1C, whereas it was negatively correlated with smoking history. These results suggest that the EPA/AA ratio may be closely intertwined with other atherosclerotic risk factors and have an influence on cardiovascular health.

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Risk factors and clinical outcomes in chronic coronary and peripheral artery disease: An analysis of the randomized, double-blind COMPASS trial

European Journal of Preventive Cardiology ◽

10.1177/2047487319882154 ◽

2019 ◽

Vol 27 (3) ◽

pp. 296-307 ◽

Cited By ~ 11

Author(s):

Thomas Vanassche ◽

Peter Verhamme ◽

Sonia S Anand ◽

Olga Shestakovska ◽

Keith AA Fox ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Peripheral Artery Disease ◽

Low Dose ◽

Cardiovascular Death ◽

Peripheral Artery ◽

Double Blind ◽

Artery Disease ◽

Risk Factor Status ◽

Ischemic Events

Aims Secondary prevention in patients with coronary artery disease and peripheral artery disease involves antithrombotic therapy and optimal control of cardiovascular risk factors. In the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) study, adding low-dose rivaroxaban on top of aspirin lowered cardiovascular events, but there is limited data about risk factor control in secondary prevention. We studied the association between risk factor status and outcomes, and the impact of risk factor status on the treatment effect of rivaroxaban, in a large contemporary population of patients with coronary artery disease or peripheral artery disease. Methods and results We reported ischemic events (cardiovascular death, stroke, or myocardial infarction) in participants from the randomized, double-blind COMPASS study by individual risk factor (blood pressure, smoking status, cholesterol level, presence of diabetes, body mass index, and level of physical activity), and by number of risk factors. We compared rates and hazard ratios of patients treated with rivaroxaban plus aspirin vs aspirin alone within each risk factor category and tested for interaction between risk factor status and antithrombotic regimen. Complete baseline risk factor status was available in 27,117 (99%) patients. Status and number of risk factors were both associated with increased risk of ischemic events. Rates of ischemic events (hazard ratio 2.2; 95% confidence interval 1.8–2.6) and cardiovascular death (hazard ratio 2.0; 1.5–2.7) were more than twofold higher in patients with 4–6 compared with 0–1 risk factors ( p < 0.0001 for both). Rivaroxaban reduced event rates independently of the number of risk factors ( p interaction 0.93), with the largest absolute benefit in patients with the highest number of risk factors. Conclusion More favorable risk factor status and low-dose rivaroxaban were independently associated with lower risk of cardiovascular events.

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Antiplatelet Drugs in the Management of Thrombotic/Ischemic Events in Peripheral Artery Disease

Platelets ◽

10.1016/b978-0-12-813456-6.00058-8 ◽

2019 ◽

pp. 1059-1066

Author(s):

Stefania Basili ◽

Francesco Violi

Keyword(s):

Peripheral Artery Disease ◽

Antiplatelet Drugs ◽

Peripheral Artery ◽

Artery Disease ◽

Ischemic Events

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Abstract 16894: The Effect of Cangrelor on Cardiovascular and Bleeding Events in Patients With Peripheral Artery Disease - Insights From CHAMPION PHOENIX

Circulation ◽

10.1161/circ.132.suppl_3.16894 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Antonio Gutierrez ◽

Robert A Harrington ◽

Gregg W Stone ◽

Ph. G Steg ◽

Michael C Gibson ◽

...

Keyword(s):

Peripheral Artery Disease ◽

Primary Endpoint ◽

Prior History ◽

Severe Bleeding ◽

Peripheral Artery ◽

Bleeding Events ◽

Double Blind ◽

Life Threatening ◽

Artery Disease ◽

Ischemic Events

Background: Patients with peripheral artery disease (PAD) are high risk for adverse cardiovascular and bleeding events. In CHAMPION-PHOENIX, cangrelor, an intravenous P2Y12 inhibitor, reduced rates of ischemic events in patients undergoing PCI. Hypothesis: We hypothesize that cangrelor will safely reduce ischemic events in patients with PAD undergoing PCI. Methods: A total of 11,145 patients were randomly assigned in a double-dummy, double-blind manner to either cangrelor followed by clopidogrel 600 mg or to clopidogrel loading at PCI. The primary endpoint was a composite of death, MI, ischemia-driven revascularization (IDR), or stent thrombosis (ST) at 48 hours. Results: 837 (8%) patients with PAD and 9,994 (90%) patients with no prior history of PAD underwent PCI. Among the PAD cohort the primary endpoint occurred in 20 (4.5%) cangrelor vs. 44 (11.4%) clopidogrel patients (OR [95% CI] = 0.36 [0.21, 0.63]), and 235 (4.7%) cangrelor vs. 276 (5.5%) clopidogrel patients (OR [95%CI] = 0.86 [0.72, 1.03]) without PAD (p for interaction = 0.003). Among the PAD cohort the rate of GUSTO severe/life-threatening bleeding was 0.4% cangrelor vs. 0% clopidogrel (p = 0.19), and 0.1% cangrelor vs. 0.1% clopidogrel patients (OR [95%CI] = 1.78 [0.52, 6.07], p = 0.35) without PAD (p for interaction = 0.34). The rate of blood transfusion in the PAD cohort was 0.9% cangrelor vs. 0% clopidogrel (p = 0.06), and 0.4% cangrelor vs. 0.3% clopidogrel patients (OR [95%CI] = 1.42 [0.73, 2.76], p = 0.30) without PAD (p for interaction = 0.13). Conclusion: In CHAMPION-PHOENIX, cangrelor significantly reduced ischemic events with no significant increase in severe bleeding or transfusions in patients with PAD.

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