The influence of atorvastatin on walking performance in peripheral arterial disease

VASA ◽  
2009 ◽  
Vol 38 (2) ◽  
pp. 155-159 ◽  
Author(s):  
Bregar ◽  
Poredoš ◽  
Šabovič ◽  
Jug ◽  
Šebeštjen

Background: Recently it has been shown that statins can improve walking distance in patients with peripheral arterial disease. We examined whether statins used in moderate dosages with the aim of reaching the target levels for hypercholesterolemia could improve walking performance in patients with peripheral arterial disease. Patients and methods: 37 patients with hypercholesterolemia (LDL cholesterol = 3.46 ± 0.13 mmol/l), who had previously not been treated by statins, were randomized in a double-blind study to a group receiving either atorvastatin at 20 mg/day (N = 20) or placebo (N = 17). All patients had stable intermittent claudication (Fontaine class IIa or IIb). At baseline, after one and three months the pain-free walking distance was measured in all patients. Results: After 3 months patients in the treated group had reached target cholesterol values (LDL cholesterol = 2,34 ± 0.9 mmol/l), whereas no significant change in lipids was observed in the control group. The ankle-brachial pressure index (ABPI) did not change significantly in either group. After 3 months the pain-free walking distance was increased significantly (p < 0.001), but similarly in both groups (at entry: 56 (53–108) m vs 53 (53–106) m; after 3 months: 79 (53–108) m vs 106 (66–159) m, for the treated and placebo group, respectively). Therefore this effect had to be attributed to regular exercise and not to statin use. Conclusions: Our results show that routine treatment with statin (atorvastatin 20 mg/day), which is effective in reducing the level of cholesterol, does not produce an improvement in walking performance in patients with peripheral arterial disease.

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 149
Author(s):  
Wagner Jorge Ribeiro Domingues ◽  
Raphael Mendes Ritti-Dias ◽  
Gabriel Grizzo Cucato ◽  
Nelson Wolosker ◽  
Antônio Eduardo Zerati ◽  
...  

The aim of the study was to verify the effects of creatine (Cr) supplementation on functional capacity (walking capacity; primary outcome) and calf muscle oxygen saturation (StO2) (secondary outcome) in symptomatic peripheral arterial disease (PAD) patients. Twenty-nine patients, of both sexes, were randomized (1:1) in a double-blind manner for administration of placebo (PLA, n = 15) or creatine monohydrate (Cr, n = 14). The supplementation protocol consisted of 20 g/day for 1 week divided into four equal doses (loading phase), followed by single daily doses of 5 g in the subsequent 7 weeks (maintenance phase). Functional capacity (total walking distance) was assessed by the 6 min walk test, and calf muscle StO2 was assessed through near infrared spectroscopy. The measurements were collected before and after loading and after the maintenance phase. The level of significance was p < 0.05. No significant differences were found for function capacity (total walking distance (PLA: pre 389 ± 123 m vs. post loading 413 ± 131 m vs. post maintenance 382 ± 99 m; Cr: pre 373 ± 149 m vs. post loading 390 ± 115 m vs. post maintenance 369 ± 115 m, p = 0.170) and the calf muscle StO2 parameters (p > 0.05). Short- and long-term Cr supplementation does not influence functional capacity and calf muscle StO2 parameters in patients with symptomatic PAD.


1990 ◽  
Vol 64 (01) ◽  
pp. 087-090 ◽  
Author(s):  
B Hoet ◽  
J Arnout ◽  
C Van Geet ◽  
H Deckmyn ◽  
R Verhaeghe ◽  
...  

SummaryThe combination of thromboxane synthase inhibition with thromboxane receptor antagonism has been shown to result in a strong inhibition of platelet aggregation and a prolongation of the bleeding time (Gresele et al., J. Clin Invest 1987;80: 1435–45).Ridogrel is a single molecule that efficiently achieves both inhibitions in human volunteers. The present study was performed in patients with obstructive peripheral arterial disease and elevated plasma β-thromboglobulin levels. Patients were treated with either 2 × 300 mg ridogrel or 2 × 300 mg placebo per day for 2½ days, according to a double blind randomised parallel design. Plasma β-thromboglobulin decreased significantly throughout active treatment starting within 2 h after administration; serum and urinary immunoreactive TxB2 levels and urinary 11-dehydro- TxB2 excretion were significantly lower and serum PGE2 and 6-keto-PcF1α levels significantly higher with ridogrel; no changes were observed in the placebo-treated group.In conclusion this study demonstrates a reduction of platelet activation in vivo by ridogrel.


VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 462-470 ◽  
Author(s):  
Gerald Hackl ◽  
Andreas Prenner ◽  
Philipp Jud ◽  
Franz Hafner ◽  
Peter Rief ◽  
...  

Abstract. Background: Auricular nerve stimulation has been proven effective in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAD) via electroacupuncture of the outer ear can be established. Patients and methods: In this prospective, double-blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAD patients in Fontaine stage IIb. Twenty patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, eight cycles (1 cycle = 1 week) of electroacupuncture were performed. The primary endpoint was defined as a significantly more frequent doubling of the absolute walking distance after eight cycles in the verum group compared to controls in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking Impairment Questionnaire (WIQ) as well as improvements in health related quality of life using the Short Form 36 Health Survey (SF-36). Results: There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group [means]: 182 [95 % CI 128–236] meters to 345 [95 % CI 227–463] meters [+ 90 %], p < 0.01; control group [means]: 159 [95 % CI 109–210] meters to 268 [95 % CI 182–366] meters [+ 69 %], p = 0.01). Twelve patients (60 %) in the verum group and five patients (25 %) in controls reached the primary endpoint of doubling walking distance (p = 0.05). The total score of WIQ significantly improved in the verum group (+ 22 %, p = 0.01) but not in controls (+ 8 %, p = 0.56). SF-36 showed significantly improvements in six out of eight categories in the verum group and only in one of eight in controls. Conclusions: Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAD patients.


Author(s):  
Tieh-Cheng Fu ◽  
Ming-Lu Lin ◽  
Chih-Chin Hsu ◽  
Shu-Chun Huang ◽  
Yu-Ting Lin ◽  
...  

AbstractExercise training influences the risk of vascular thrombosis in patients with peripheral arterial disease (PAD). Mitochondrial functionalities in platelets involve the cellular bioenergetics and thrombogenesis. This study aimed to elucidate the effect of cycling exercise training (CET) on platelet mitochondrial bioenergetics in PAD patients. Forty randomly selected patients with PAD engaged in general rehabilitation (GR) with CET (i.e., cycling exercise at ventilation threshold for 30 minute/day, 3 days/week) (GR + CET, n = 20) or to a control group that only received GR course (n = 20) for 12 weeks. Systemic aerobic capacity and platelet mitochondrial bioenergetics that included oxidative phosphorylation (OXPHOS) and electron transport system (ETS) were measured using automatic gas analysis and high-resolution respirometry, respectively. The experimental results demonstrated that GR + CET for 12 weeks significantly (1) elevated VO2peak and lowered VE-VCO2 slope, (2) raised resting ankle-brachial index and enhanced cardiac output response to exercise, (3) increased the distance in 6-minute walk test and raised the Short Form-36 physical/mental component scores, and (4) enhanced capacities of mitochondrial OXPHOS and ETS in platelets by activating FADH2 (complex II)-dependent pathway. Moreover, changes in VO2peak levels were positively associated with changes in platelet OXPHOS and ETS capacities. However, no significant changes in systemic aerobic capacity, platelet mitochondrial bioenergetics, and health-related quality of life (HRQoL) occurred following GR alone. Hence, we conclude that CET effectively increases the capacities of platelet mitochondrial bioenergetics by enhancing complex II activity in patients with PAD. Moreover, the exercise regimen also enhanced functional exercise capacity, consequently improving HRQoL in PAD patients.


2020 ◽  
Vol 7 (1) ◽  
pp. 62-67
Author(s):  
Nandang Jamiat Nugraha ◽  
Rahmat Rahmat

Diabetes Mellitus (DM) merupakan penyakit yang tidak dapat disembuhkan, namun dapat dikendalikan. Prevalensi penderita DM di Indonesia 6.9% dan di Jawa Barat sekitar 29,4% dari jumlah penduduknya. Sebagai mother of desease, penyakit DM memiliki komplikasi yang serius seperti retinopati diabetik, neuropati, amputasi, penyakit jantung, gagal jantung, stroke dan peripheral arterial disease. Kondisi tersebut menunjukkan perlunya keseriusan dalam penanganan penyakit DM. Diperlukan dukungan dari kader (sebagai bagian dari support group) bagi peserta prolanis DM. Tujuan penelitian ini adalah untuk mengetahui implementasi metoda support group dalam meningkatkan persepsi pasien tentang perawatan DM di Kota Bandung. Penelitian ini termasuk jenis penelitian kuantitatif dengan menggunakan rancangan quasi experiment dengan pretest and post test non equivalent control group. Hasil penelitian menunjukkan peningkatan persepsi pasien prolanis sebesar 3,08 dan peningkatannya dinyatakan sangat bermakna (p<0,01).  Edukasi yang dilakukan kader (support group) berpengaruh terhadap peningkatan persepsi pasien DM. Metode support group dengan memberdayakan kader dalam memberikan edukasi sangat bermanfaat dan dapat dijadikan kebijakan di pelayanan kesehatan masyarakat.


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