scholarly journals Marine and plant-based n-3 PUFA and atherosclerotic cardiovascular disease

2019 ◽  
Vol 79 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Christian S. Bork ◽  
Stine K. Venø ◽  
Anne N. Lasota ◽  
Søren Lundbye-Christensen ◽  
Erik B. Schmidt
Keyword(s):  
Ischaemic Stroke ◽  
Arterial Disease ◽  
Atherosclerotic Cardiovascular Disease ◽  
Peripheral Artery ◽  
Ascvd Risk ◽  
Artery Disease ◽  
Atherosclerotic Process ◽  
Peripheral Arterial

n-3 PUFA may exert favourable effects on several processes that may inhibit the atherosclerotic process. However, the role of n-3 PUFA in lowering the risk of atherosclerotic CVD (ASCVD) has been fiercely debated. In the present paper, we summarise the main findings from previous follow-up studies of intake and studies using adipose tissue as an objective biomarker to investigate exposure to n-3 PUFA in relation to ASCVD risk and discuss some perspectives for further research. The majority of previous studies investigating intake of marine- and plant-based n-3 PUFA have focused on CHD while other ASCVD such as ischaemic stroke and peripheral artery disease have been less studied. However, recent data from Danish Diet, Cancer and Health cohort suggest that marine n-3 PUFA may be inversely associated with risk of myocardial infarction, ischaemic stroke and peripheral arterial disease caused by atherosclerosis. The effect of the plant-derived n-3 PUFA α-linolenic acid on ASCVD is less clear and several gaps in the literature remain to be explored.

scholarly journals Inflammatory Burden but Not Diabetes Mellitus Influences in Prognosis of Endovascular Revascularization in Peripheral Arterial Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Silvia Bleda ◽  
Joaquin de Haro ◽  
Cesar Varela ◽  
Ignacio Lopez de Maturana ◽  
Javier Rodriguez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Endovascular Therapy ◽  
Arterial Disease ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Peripheral Arterial ◽  
Inflammatory Burden

Aims. To determine the effect of inflammatory preoperative burden on the incidence of reintervention and mortality after endovascular therapy (EVT) and to investigate if diabetes mellitus (DM) is involved in these results. Material and Methods. A prospective cohort study with 12-month follow-up period in patients with peripheral artery disease was carried out. hsCRP and fibrinogen assessments were determined. Results. 85 diabetic and 58 nondiabetic patients were included. An increase between basal hsCRP (11.8 mg/L (10.2; 21.5) versus 4.3 mg/L (1.8; 13.9), P<0.001) and fibrinogen levels (450 mg/dL (425; 479.1) versus 369 mg/dL (268; 419), P<0.001) and the incidence of death during followup was found. A significant increase between higher hsCRP and fibrinogen basal levels and the incidence of reintervention during the follow-up period was also noted (P=0.001 and P=0.04, resp.,). There was no difference between DM and non-DM patients in the 1-year need of reintervention (33.3% versus 45%, P=0.15, resp.,). Basal hsCRP and fibrinogen levels did not significantly differ between DM and non-DM patients who needed reintervention. Conclusions. The prognosis of the EVT is likely marked by the previous inflammatory load, regardless of DM.

scholarly journals Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251542
Author(s):  
Byoung Geol Choi ◽  
Ji-Yeon Hong ◽  
Seung-Woon Rha ◽  
Cheol Ung Choi ◽  
Michael S. Lee
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Significant Coronary Artery Disease ◽  
Arterial Disease ◽  
Term Survival ◽  
Artery Disease ◽  
Peripheral Arterial

Background Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angioplasty (PTA) is unclear. Methods A total of 765 consecutive PAD patients underwent successful PTA and 674 patients (88.1%) underwent routine CAG. Coronary artery disease (CAD) was defined as angiographic stenosis ≥70%. Patients were divided into three groups; 1) routine CAG and a presence of CAD (n = 413 patients), 2) routine CAG and no CAD group (n = 261 patients), and 3) no CAG group (n = 91 patients). To adjust for any potential confounders that could cause bias, multivariable Cox-proportional hazards regression and propensity score matching (PSM) analysis was performed. Clinical outcomes were evaluated by Kaplan-Meier curved analysis at 5-year follow-up. Results In this study, the 5-year survival rate of patients with PAD who underwent PTA was 88.5%. Survival rates were similar among the CAD group, the no CAD group, and the no CAG group, respectively (87.7% vs. 90.4% vs. 86.8% P = 0.241). After PSM analysis between the CAD group and the no CAD group, during the 5-year clinical follow-up, there were no differences in the incidence of death, myocardial infarction, strokes, peripheral revascularization, or target extremity surgeries between the two groups except for repeat PCI, which was higher in the CAD group than the non-CAD group (9.3% vs. 0.8%, P<0.001). Conclusion PAD patients with CAD were expected to have very poor long-term survival, but they are shown no different long-term prognosis such as mortality compared to PAD patients without CAD. These PAD patients with CAD had received PCI and/or optimal medication treatment after the CAG. Therefore a strategy of routine CAG and subsequent PCI, if required, appears to be a reasonable strategy for mortality risk reduction of PAD patients. Our results highlight the importance for evaluation for CAD in patients with PAD.

scholarly journals Anticoagulation in Patients with Ischaemic Heart Disease and Peripheral Arterial Disease: Clinical Implications of COMPASS Study

2018 ◽  
Vol 13 (2) ◽  
pp. 115 ◽  
Author(s):  
Josep Gradolí ◽  
Verónica Vidal ◽  
Adrian JB Brady ◽  
Lorenzo Facila ◽  
◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Arterial Disease ◽  
Platelet Inhibition ◽  
Clinical Implications ◽  
Peripheral Artery ◽  
Everyday Clinical Practice ◽  
Major Cardiovascular Events ◽  
Novel Oral Anticoagulant ◽  
Artery Disease ◽  
Peripheral Arterial

Patients with established cardiovascular disease may suffer further cardiovascular events, despite receiving optimal medical treatment. Although platelet inhibition plays a central role in the prevention of new events, the use of anticoagulant therapies to reduce events in atheromatous disease has, until recently, been overlooked. The recent Rivaroxaban for the Prevention of Major Cardiovascular Events in Coronary or Peripheral Artery Disease (COMPASS) study showed an important reduction in cardiovascular events without increasing the risk of fatal and intracranial bleeding when using rivaroxaban, a novel oral anticoagulant, combined with aspirin. This article reviews the available evidence regarding the use of anticoagulant therapies for prevention of cardiovascular events, the results of the COMPASS study and how these results may affect patient management in everyday clinical practice.

scholarly journals The Role of the Stem Cells Therapy in the Peripheral Artery Disease

2019 ◽  
Vol 20 (9) ◽  
pp. 2233 ◽  
Author(s):  
Federico Biscetti ◽  
Nicola Bonadia ◽  
Elisabetta Nardella ◽  
Andrea Leonardo Cecchini ◽  
Raffaele Landolfi ◽  
...  
Keyword(s):  
Stem Cells ◽  
Vascular Complications ◽  
Arterial Disease ◽  
Definitive Treatment ◽  
Stem Cells Therapy ◽  
Artery Disease ◽  
The Moment ◽  
Peripheral Arterial

Vascular complications of diabetes mellitus are an important issue for all clinicians involved in the management of this complex pathology. Although many therapeutic advances have been reached, peripheral arterial disease is still an unsolved problem that each year compromises the quality of life and life span of affected patients. Oftentimes, patients, after ineffective attempts of revascularization, undergo greater amputations. At the moment, there is no effective and definitive treatment available. In this scenario, the therapeutic use of stem cells could be an interesting option. The aim of the present review is to gather all the best available evidence in this regard and to define a new role of the stem cells therapy in this field, from biomarker to possible therapeutic target.

P1737Influence of peripheral arterial disease on prognosis in patients with left main coronary artery disease treated with percutaneous coronary intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Martinez Leon ◽  
A Adeba Garcia ◽  
D Garcia Iglesias ◽  
P Florez Llano ◽  
A Flores Fuentes ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Multivariate Analysis ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Arterial Disease ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Peripheral Arterial

Abstract Introduction Percutaneous coronary intervention (PCI) in patients with left main (LM) coronary artery disease is acquiring an important role in the last years as an alternative to coronary artery bypass grafting (CABG) in selected patients. The objective of the study was to evaluate predictors of mortality in patients with LM coronary artery disease treated with PCI. Methods Prospective and observational study of consecutive patients referred to our centre for coronary angiography, with LM coronary artery disease, whom PCI was decided in a “Heart team” as a strategy for revascularization between July 2015 and December 2017. Baseline clinical, analytical and coronary angiography data were collected. Follow-up was conducted in person or by telephone for a minimum of one year. We analysed the predictive variables of mortality by means of an uni and multivariate logistic regression model. In addition, a survival analysis was performed. Results A total of 191 patients were recruited. The average age was 72 years (±11.4), 79% males. 42% had previous documented coronary artery disease. PCI was performed in the context of acute coronary syndrome in 81% of them. The mean follow-up period was 17.9 months (± 8.3). After multivariate analysis, the following variables remained as independent predictors of mortality: the hemodynamic situation of the patient, assessed by the Killip-Kimball scale (OR 1.58, 95% CI 1.03–2.43; p=0.04) and the presence of peripheral arterial disease (PAD) (OR 2.61, 95% CI 1.03–6.67; p=0.04) (table 1). The ROC curve of the multivariate model showed an AUC of 0.796 (figure 1A). In the survival analysis, patients with PAD had a significantly lower survival, with a median survival of 6 months, compared to 13.9 months in those without PAD, with p=0.008 (figure 1B). Uni and multivariate analysis Univariate analysis Multivariate analysis OR (95% CI) p OR (95% CI) p Killip-Kimbal scale 1.94 (1.39–2.72) 0 1.58 (1.03–2.43) 0.04 LVEF 0.96 (0.93–0.99) 0.01 0.99 (0.95–1.03) 0.46 Mitral regurgitation 2.54 (1.12–5.63) 0.02 1.60 (0.55–4.56) 0.38 Number of affected vessels 1.96 (1.24–3.29) 0.01 1.78 (1.03–3.37) 0.05 PAD 2.54 (1.16–5.49) 0.02 2.61 (1.03–6.67) 0.,04 Figure 1 Conclusion Although PCI revascularization of LM coronary artery disease is an attractive alternative to CABG in selected patients, a word of caution should be raised in patients with PAD, as in the present study this variable was an important predictor of short-medium term mortality.

scholarly journals Association between Peripheral Arterial Disease and Coronary Artery Disease among Tobacco User Diabetic Patients

2017 ◽  
Vol 32 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Syed Dawood Md Taimur ◽  
M Maksumul Haq ◽  
MA Rashid ◽  
SM Keramat Ali ◽  
Md Shahjahan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Tobacco User ◽  
Group I ◽  
Artery Disease ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is a marker of increased risk for cardiovascular events and of poorer prognosis in patients with coronary artery disease (CAD). The prevalence of unknown PAD amongst patients with ACS varies between studies according to the mode of diagnosis.Aims: To evaluate the prevalence of peripheral arterial disease (PAD) in diabetic ACS patients with or without tobacco user by using ankle brachial index (ABI).We also assess the probable predictors of PAD among these patients.Methodology: This prospective observational study was conducted in the Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh starting from 1st January 2016 to 30th April 2016 over a period of four months. A total of 60 patients were studied. They were grouped on the basis of their smoking habit. Diabetic patients with ACS and tobacco user (smoke and smoke less) in group I and without tobacco user in group II.Results: The mean age of the studied patients was 56.63 ± 8.95 years, range from 25-90 years. 73.30% was male and 26.70% was female. Twenty three patients of tobacco user in group-I (n=30) had peripheral artery disease and ten patients of group-II (n=30) had peripheral artery disease. It was statistically significant (p=0.003).Conclusion: There is correlation between peripheral arterial disease and coronary artery disease. Diagnosis and supervision of patients with PAD is important for preventing the local progression of the disease and effective secondary prevention of future coronary and cerebrovascular events.Bangladesh Heart Journal 2017; 32(1) : 3-9

Dobutamine stress cardiovascular magnetic resonance imaging in patients with peripheral artery disease

2011 ◽  
Vol 152 (8) ◽  
pp. 285-291 ◽  
Author(s):  
Róbert Kirschner ◽  
Zsolt Pécsvárady ◽  
J. Róbert Bedros ◽  
Levente Tóth ◽  
Krisztián Kiss ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Peripheral Artery Disease ◽  
Wall Motion ◽  
Arterial Disease ◽  
Dobutamine Stress ◽  
Cardiovascular Mri ◽  
Peripheral Artery ◽  
Target Heart Rate ◽  
Artery Disease ◽  
Peripheral Arterial

Patients with peripheral arterial disease often have coronary heart disease, as well. However, their assessment with classical noninvasive cardiology methods is often non-diagnostic or limited. The aim of this study was to analyze the feasibility and the risks of dobutamine stress cardiovascular MRI for cardiac evaluation of patients with peripheral arterial disease. 21 patients with peripheral artery disease (mean±SD age 64.3±7.7 years) were studied prospectively with dobutamine stress cardiovascular MRI. The protocol was completed by all of 21 patients. The target heart rate was attained in 95.2% of the studies. No serious adverse event occurred. The image quality scores (1-4) for all ventricular wall segments were high (median, interquartile range) (4 [4-4]). Five patients (23.8%) have inducible wall motion abnormality. Interobserver agreement was almost perfect for wall motion scores (κ = 0.87, p<0.0001). Dobutamine stress cardiovascular MRI is feasible with low risk for the cardiological assessment of patients with peripheral arterial disease. Orv. Hetil., 2011, 152, 285–291.

scholarly journals A Comparison of Measures of Endothelial Function in Patients with Peripheral Arterial Disease and Age and Gender Matched Controls

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Richard B. Allan ◽  
Simon V. Vun ◽  
J. Ian Spark
Keyword(s):  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Arterial Disease ◽  
Peripheral Artery ◽  
Flow Mediated Dilatation ◽  
Hyperaemic Response ◽  
Artery Disease ◽  
And Gender ◽  
Peripheral Arterial ◽  
And Control

This study compared flow-mediated dilatation (FMD), peripheral artery tonometry (PAT), and serum nitric oxide (NO) measures of endothelial function in patients with peripheral artery disease (PAD) against age/gender matched controls. 25 patients (mean age: 72.4 years, M : F 18 : 7) with established PAD and an age/gender matched group of 25 healthy controls (mean age: 72.4 years, M : F 18 : 7) were studied. Endothelial function was measured using the % FMD, reactive hyperemia index (RHI) using PAT and serum NO (μmol). Difference for each method between PAD and control patients and correlation between the methods were investigated. FMD and RHI were lower in patients with PAD (median FMD for PAD = 2.16% versus control = 3.77%,p=0.034and median RHI in PAD = 1.64 versus control = 1.92,p=0.005). NO levels were not significantly different between the groups (PAD median = 7.70 μmol, control median = 13.05 μmol,p=0.662). These results were obtained in elderly patients and cannot be extrapolated to younger individuals. FMD and PAT both demonstrated a lower hyperaemic response in patients with PAD; however, FMD results in PAD patients were unequivocally reduced whereas half the PAD patients had RHI values above the established threshold for endothelial dysfunction. This suggests that FMD is a more appropriate method for the measurement of NO-mediated endothelial function.

scholarly journals Paclitaxel Exposure and Dosage of Drug-coated Devices for the Treatment of Femoropopliteal Peripheral Artery Disease

2021 ◽  
Vol 4 ◽  
Author(s):  
Ceazón T Edwards ◽  
Peter A Schneider ◽  
Cindy Huynh
Keyword(s):  
Dose Response ◽  
Meta Analysis ◽  
Arterial Disease ◽  
Long Term Results ◽  
Real Patient ◽  
All Cause Mortality ◽  
Artery Disease ◽  
Peripheral Arterial

The role of paclitaxel in the treatment of femoropopliteal peripheral arterial disease is currently ambiguous. A summary-level meta-analysis of randomised trials published in 2018 demonstrated that paclitaxel-coated devices were associated with an increased all-cause mortality in those who underwent treatment at 2 years and 5 years. Further evaluation has been undertaken to establish whether there is a specific dose response, mechanism or reproducible signal. At this time, there has been no confirmation of dose response, as was initially asserted by the summary-level meta-analysis. No mechanism of harm has been identified. Although an association with increased mortality has been confirmed by patient-level meta-analysis, the strength of the signal has been inconsistent. The information suggests there is only an association between paclitaxel-coated devices and increased all-cause mortality, not causation. The authors encourage additional studies designed to follow long-term results after treatment with paclitaxel-coated devices, using real patient data, before a conclusion can be made.

scholarly journals The Toll of Vascular Insufficiency: Implications for the Management of Peripheral Arterial Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jun Xu ◽  
Ulka Sachdev
Keyword(s):  
Arterial Disease ◽  
Toll Like Receptor ◽  
Tlr Signaling ◽  
Cardiovascular Research ◽  
Vascular Insufficiency ◽  
Cardiovascular Biology ◽  
Arterial Insufficiency ◽  
Artery Disease ◽  
Peripheral Arterial

Peripheral artery disease (PAD) can result in limb loss within six months of diagnosis in a subset of patients who cannot undergo endovascular or surgical revascularization yet continues to maintain a marginal position in cardiovascular research. While a body of literature continues to grow describing the role of danger signaling and innate immunity in cardiac biology, the role of these pathways in the ischemic myopathy associated with PAD has not been extensively studied. The following report will review the current literature on the role of Toll-like receptor (TLR) signaling in cardiovascular biology as well as in nonischemic myopathy. While attenuation of TLR signaling has not been shown to be clinically useful in the treatment of infectious inflammation, it may show promise in the management of severe arterial insufficiency.

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