scholarly journals INTERACTION OF SMOKING STATUS ON THE ASSOCIATION OF BODY MASS INDEX WITH MAJOR ADVERSE LIMB OUTCOMES IN PERIPHERAL ARTERY DISEASE INSIGHTS FROM THE REACH REGISTRY

2019 ◽  
Vol 73 (9) ◽  
pp. 2101
Author(s):  
Poghni Peri-Okonny ◽  
Philip Jones ◽  
Elizabeth Magnuson ◽  
John A. Spertus ◽  
Vittal Hijjaji ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Peripheral Artery Disease ◽  
Smoking Status ◽  
Peripheral Artery ◽  
Artery Disease

Body mass index and outcome in patients with coronary, cerebrovascular, or peripheral artery disease: findings from the FRENA registry

2009 ◽  
Vol 16 (4) ◽  
pp. 457-463 ◽  
Author(s):  
Raquel Barba ◽  
Josep Bisbe ◽  
José Nicolas Alcalá Pedrajas ◽  
Jesús Toril ◽  
Rafael Monte ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cerebrovascular Disease ◽  
Body Mass ◽  
Peripheral Artery Disease ◽  
Cardiovascular Mortality ◽  
Inverse Correlation ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Peripheral Artery ◽  
Artery Disease

Background The relationship between body mass index (BMI) and mortality in patients with established arterial disease remains controversial. Methods FRENA is an ongoing, observational registry of consecutive outpatients with coronary artery disease (CAD), cerebrovascular disease, or peripheral artery disease (PAD). We examined the prognostic importance of accepted BMI categories on outcome among patients in the FRENA registry. Results In April 2008, 2274 patients (mean age, 66 years) had been enrolled, of whom 14 (0.6%) were underweight; 533 (23%) normal; 1051 (46%) overweight; and 676 (30%) were obese. Over a mean follow-up of 14 months, the incidence of major cardiovascular events (myocardial infarction, ischemic stroke, or critical limb ischemia) per 100 patient-years was: 7.1 [95% confidence interval (CI): 0.4–35]; 11 (95% CI: 8.4–14); 6.9 (95% CI: 5.6–8.5); and 8.5 (95% CI: 6.6–11), respectively. Their cardiovascular mortality was: 7.1 (95% CI: 0.4–35); 4.1 (95% CI: 5.9–11); 1.3 (95% CI: 0.9–2.3); and 1.5 (95% CI: 1.4–3.5), respectively. On multivariate analysis, the hazard ratio for cardiovascular mortality was: 2.2 (95% CI: 0.3–17); 1.0 (reference); 0.37 (95% CI: 0.20–0.69); and 0.37 (95% CI: 0.18–0.73), respectively. Survival benefit was only found in patients with CAD or PAD. Weight loss had little influence on outcome. Conclusion Patients with CAD or PAD (not those with cerebrovascular disease) have an inverse correlation between BMI and cardiovascular mortality, even after adjusting for confounding variables.

scholarly journals Body mass index and peripheral artery disease

2020 ◽  
Vol 292 ◽  
pp. 31-36 ◽  
Author(s):  
Sean P. Heffron ◽  
Aeshita Dwivedi ◽  
Caron B. Rockman ◽  
Yuhe Xia ◽  
Yu Guo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

Association Between Underweight Body Mass Index and In-Hospital Outcome in Patients Undergoing Endovascular Interventions for Peripheral Artery Disease: A Propensity Score Matching Analysis

2019 ◽  
Vol 26 (3) ◽  
pp. 411-417 ◽  
Author(s):  
Homam Moussa Pacha ◽  
Yasser Al-khadra ◽  
Fahed Darmoch ◽  
Mohamad Soud ◽  
Amir Kaki ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Body Mass ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Propensity Score Matching Analysis ◽  
Significant Difference ◽  
Low Bmi ◽  
Artery Disease

Purpose: To investigate in-hospital outcomes after endovascular therapy (EVT) in patients with severe peripheral artery disease (PAD) who had a low body mass index (BMI, kg/m2) compared to those with normal BMI. Materials and Methods: Using weighted data from the National Inpatient Sample (NIS) database between 2002 and 2014 and ICD-9 codes, 2614 patients were identified who were aged ≥18 years and underwent EVT for PAD in the lower limb vessels. EVT was defined as angioplasty, atherectomy, and/or stenting. After excluding individuals with BMI >24, there were 807 (31%) normal-weight (BMI 19–24) patients and 1807 (69%) underweight (BMI <19) individuals. All patients in both groups were matched for baseline demographic and clinical characteristics and critical limb ischemia in a 1:1 propensity score matching analysis using the nearest neighbor method. Results: Propensity score matching produced 2 groups of 685 patients that differed only in the incidence of chronic lung disease, which was more frequent in low-BMI patients (p=0.04). Patients with low BMI had a higher incidence of in-hospital mortality (4.8% vs 1.2%, p<0.001), major adverse cardiovascular events (composite of death, myocardial infarction, or stroke) (7.9% vs 4.1%, p=0.003), open bypass surgery (9.1% vs 6.0%, p=0.03), and infection (14.6% vs 10.5%, p=0.02) compared with the normal-BMI group. There was no significant difference in the incidence of vascular complications (p=0.31), major bleeding (p=0.17), major amputation (p=0.35), or acute kidney injury (p=0.09) between the low- and normal-BMI groups. Conclusion: Low-BMI patients with PAD have worse in-hospital survival and more adverse outcomes after EVT.

scholarly journals Midlife Cardiorespiratory Fitness and the Development of Peripheral Artery Disease in Later Life

2021 ◽  
Author(s):  
Neil Keshvani ◽  
Benjamin Willis ◽  
David Leonard ◽  
Ang Gao ◽  
Laura DeFina ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Cardiorespiratory Fitness ◽  
Peripheral Artery Disease ◽  
Lower Risk ◽  
Later Life ◽  
Peripheral Artery ◽  
Metabolic Equivalent ◽  
Metabolic Equivalent Task ◽  
Artery Disease

Background Data are sparse on the prospective associations between physical activity and incidence of lower extremity peripheral artery disease (PAD). Methods and Results Linking participant data from the CCLS (Cooper Center Longitudinal Study) to Medicare claims files, we studied 19 023 participants with objectively measured midlife cardiorespiratory fitness through maximal effort on the Balke protocol who survived to receive Medicare coverage between 1999 and 2009. The study aimed to determine the association between midlife cardiorespiratory fitness and incident PAD with proportional hazards intensity models, adjusted for age, sex, body mass index, and other covariates, to PAD failure time data. During 121 288 person‐years of Medicare follow‐up, we observed 805 PAD‐related hospitalizations/procedures among 19 023 participants (21% women, median age 50 years). Lower midlife fitness was associated with a higher rate of incident PAD in patients aged 65 years and older (low fit [quintile 1]: 11.4, moderate fit [quintile 2 to 3]: 7.8, and high fit [quintile 4 to 5]: 5.7 per 1000 person years). After multivariable adjustment for common predictors of incident PAD such as age, body mass index, hypertension, and diabetes, these findings persisted. Lower risk for PAD per greater metabolic equivalent task of fitness was observed (hazard ratio [HR], 0.93 [95% CI, 0.90–0.97]; P <0.001). Among a subset of patients with an additional fitness assessment, each 1 metabolic equivalent task increase from baseline fitness was associated with decreased risk of incident PAD (HR, 0.90 [95% CI, 0.82–0.99]; P =0.03). Conclusions Cardiorespiratory fitness in healthy, middle‐aged adults is associated with lower risk of incident PAD in later life, independent of other predictors of incident PAD.

scholarly journals Body composition and mortality in patients undergoing endovascular treatment for peripheral artery disease

2021 ◽  
Author(s):  
Tadashi Itagaki ◽  
Soichiro Ebisawa ◽  
Kyuhachi Otagiri ◽  
Tamon Kato ◽  
Takashi Miura ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Composition ◽  
Endovascular Treatment ◽  
Body Mass ◽  
Peripheral Artery Disease ◽  
Major Amputation ◽  
Amputation Rate ◽  
Peripheral Artery ◽  
Artery Disease ◽  
The Impact

AbstractAn inverse correlation between body mass index and mortality in patients with peripheral artery disease (PAD) has been reported. However, little information is available regarding the impact of body composition on the clinical outcomes in patients with PAD. This study evaluated the relationships between the lean body mass index (LBMI), body fat % (BF%), and mortality and major amputation rate in patients with PAD. We evaluated 320 patients with PAD after endovascular treatment (EVT) enrolled from August 2015 to July 2016 and divided them into low and high LBMI and BF% groups based on their median values (17.47 kg/m2 and 22.07%, respectively). We assessed 3-year mortality and major amputation for the following patient groups: Low LBMI/Low BF%, Low LBMI/High BF%, High LBMI/Low BF%, and High LBMI/High BF%. During the median 3.1-year follow-up period, 70 (21.9%) patients died and 9 (2.9%) patients experienced major amputation. The survival rate was lower in the Low LBMI than in the High LBMI group, and was not significantly different between the Low and High BF% groups. Survival rates were lowest in the Low LBMI/Low BF% group (57.5%) and highest in the High LBMI/High BF% group (94.4%). There were no significant differences in major amputation rate between the Low LBMI and High LBMI groups, and between the Low BF% and High BF% groups. The Low LBMI and Low BF% groups were associated with an increased risk of mortality after adjustment for age, sex, frailty and conventional risk factors [hazard ratio (HR): 4.02; 95% confidence interval (CI) 2.10–7.70; p < 0.001 and HR: 4.48; 95% CI 1.58–12.68, p = 0.005, respectively], for age, sex, hemodialysis, and prior cerebral cardiovascular disease (HR: 3.63; 95% CI 1.93–6.82; p < 0.001 and HR: 4.03; 95% CI 1.43–11.42, p = 0.009, respectively) and for age, sex, and laboratory date (HR: 3.97; 95% CI 1.88–8.37; p < 0.001 and HR: 3.31; 95% CI 1.15–9.53, p = 0.026, respectively). In conclusion, Low LBMI and Low BF% were associated with poor prognosis in patients undergoing EVT for PAD, and mortality was the lowest in the High LBMI/High BF% group compared with other body composition groups.

P1960Endothelial progenitor cells are associated with cardiovascular outcome in patients with peripheral artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Pesau ◽  
C Hoebaus ◽  
B Zierfuss ◽  
R Koppensteiner ◽  
G H Schernthaner
Keyword(s):  
Progenitor Cells ◽  
Peripheral Artery Disease ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Smoking Status ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Kaplan Meier ◽  
Artery Disease

Abstract Background and introduction Endothelial dysfunction and associated cells are an important cornerstone in the development and progression of peripheral artery disease (PAD). Endothelial progenitor cells (EPC) are released from the bone marrow and have exhibited the potential for cardiovascular repair. Higher EPC levels have been linked to longer event-free survival in coronary artery disease. Similar evaluation of EPC on mortality in PAD is lacking. Purpose The current study aimed to evaluate the possible association between EPC levels and mortality in PAD patients. Methods EPC were measured in 367 PAD patients (age 69.22±10.3, 66.5% male, Fontaine stage I-II) by flow cytometry using the cell surface marker CD34+ and CD309+. Patients were followed for seven years to assess all cause and cardiovascular mortality. Patients were categorized into quartiles according to EPC levels for further analyses. Statistics included Kaplan-Meier and Cox regression. Results 89 patients died over the observation period. ICD-codes indicated a cardiovascular cause in 58 patients. The group with the highest count of EPC showed a trend towards higher all-cause mortality (p=0.070) and a significant association with cardiovascular mortality (p=0.002). Multivariable adjustment for age, c-reactive protein, systolic blood pressure, renal function (creatinine and urinary albumin), low density lipoprotein cholesterol, HbA1c, and smoking status revealed the EPC quartile to be an independent risk factor for cardiovascular mortality (p=0.016). Conclusion Increased levels of CD34+CD309+ cells are independently associated with long-term cardiovascular mortality in PAD patients.

scholarly journals Genome-Wide Association Study of Peripheral Artery Disease

2021 ◽  
Author(s):  
Natalie R. van Zuydam ◽  
Alexander Stiby ◽  
Moustafa Abdalla ◽  
Erin Austin ◽  
Emma H. Dahlström ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Odds Ratio ◽  
Genome Wide Association Study ◽  
Smoking Status ◽  
Genome Wide Association ◽  
European Ancestry ◽  
Peripheral Artery ◽  
Mortality And Morbidity ◽  
Genome Wide ◽  
Artery Disease

Background: Peripheral artery disease (PAD) affects >200 million people worldwide and is associated with high mortality and morbidity. We sought to identify genomic variants associated with PAD overall and in the contexts of diabetes and smoking status. Methods: We identified genetic variants associated with PAD and then meta-analyzed with published summary statistics from the Million Veterans Program and UK Biobank to replicate their findings. Next, we ran stratified genome-wide association analysis in ever smokers, never smokers, individuals with diabetes, and individuals with no history of diabetes and corresponding interaction analyses, to identify variants that modify the risk of PAD dependent on diabetic or smoking status. Results: We identified 5 genome-wide significant ( P association ≤5×10 −8 ) associations with PAD in 449 548 (N cases =12 086) individuals of European ancestry near LPA , CDKN2BAS1 , SH2B3-PTPN11 , HDAC9 , and CHRNA5 loci (which overlapped previously reported associations). Meta-analysis with variants previously association with PAD showed that 18 of 19 published variants remained genome-wide significant. In individuals with diabetes, rs116405693 at the CCSER1 locus was associated with PAD (odds ratio [95% CI], 1.51 [1.32–1.74], P diabetes =2.5×10 −9 , P interactionwithdiabetes =5.3×10 −7 ). Furthermore, in smokers, rs12910984 at the CHRNA3 locus was associated with PAD (odds ratio [95% CI], 1.15 [1.11–1.19], P smokers =9.3×10 −10 , P interactionwithsmoking =3.9×10 −5 ). Conclusions: Our analyses confirm the published genetic associations with PAD and identify novel variants that may influence susceptibility to PAD in the context of diabetes or smoking status.

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