scholarly journals Association of Coronary artery Calcification and Thoracic Aortic Calcification with incident peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis (MESA)

2021 ◽  
Author(s):  
Hooman Bakhshi ◽  
Pramita Bagchi ◽  
Zahra Meyghani ◽  
Behnam Tehrani ◽  
Xiaoxiao Qian ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Multivariable Analysis ◽  
Calcium Score ◽  
Arterial Disease ◽  
Traditional Cardiovascular Risk Factor ◽  
Ethnic Study ◽  
Unit Increase ◽  
Peripheral Arterial

Abstract Aim The association of subclinical atherosclerotic disease in the coronary arteries and thoracic aorta with incident peripheral arterial disease (PAD) is unknown. We investigated the association between coronary artery calcium score (CACs) and thoracic aortic calcium score (TACs) with incident clinical and subclinical PAD. Methods and results The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6,814 men and women aged 45 to 84 from four ethnic groups who were free of clinical cardiovascular disease at enrollment. CACs and TACs were measured from computed tomography scans. Participants with a baseline ABI≤0.90 or > 1.4 were excluded. Abnormal ABI was defined as ABI≤ 0.9 or > 1.4 at follow up exam. Multivariable logistic regression and Cox proportional hazards models were used to test the associations between baseline CACs and TACs with incident abnormal ABI and clinical PAD respectively. A total of 6,409 participants (female: 52.8%) with a mean age of 61 years were analyzed. Over a median follow up of 16.7 years, 91 participants developed clinical PAD. In multivariable analysis, each unit increase in log (CACS+1) and log (TACs+1) were associated with 23% and 13% (P < 0.01for both) higher risk of incident clinical PAD, respectively. In 5,725 (female:52.6%) participants with an available follow up ABI over median 9.2 years, each 1-unit increase in log (CACs+1) and log (TACs+1) were independently associated with 1.15-fold and 1.07-fold (P < 0.01for both) higher odds of incident abnormal ABI respectively. Conclusions Higher baseline CACs and TACs predict abnormal ABI and clinical PAD independent of traditional cardiovascular risk factor and baseline ABI.

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.

Abstract 13514: Gender-Stratified Difference in the Association Between Coronary Artery Calcium and Incident Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hooman Bakhshi ◽  
PRAMITA BAGCHI ◽  
Zahra Meyghani ◽  
Behnam N Tehrani ◽  
Parveen K Garg ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Peripheral Artery Disease ◽  
Coronary Artery Calcium ◽  
Multivariable Analysis ◽  
Traditional Cardiovascular Risk Factor ◽  
Peripheral Artery ◽  
Ethnic Study ◽  
Artery Disease

Introduction: Coronary artery calcium score (CACs) measured by non-contrast cardiac CT has a strong correlation with coronary atherosclerotic burden. Although CACs predicts incident coronary heart disease, its gender-specific association with incident peripheral artery disease (PAD) is not clear. Methods: The multi-ethnic study of atherosclerosis (MESA) is a prospective population-based cohort consisting of 6814 men and female free of overt cardiovascular disease at enrollment. In this study we included MESA participants with baseline CACs and at least one ankle brachial index (ABI) measured at follow up exams. We excluded participants with baseline ABI≤ 0.9 or> 1.4. Incident PAD was defined as a follow up ABI≤ 0.9 and decline of ≥15%. Multivariable logistic regression models were deployed to evaluate the association between baseline CACs and incident PAD in female and male. Results: The mean age (SD) was 61.29 (9.96) years and 52.6% (3013/5725) were female. Female had lower baseline ABI [1.10 (0.08) vs 1.15 (0.09); p < 0.001]. Over a median (IQR) of 9.23 (8.22-9.60) years, 113(4%) female and 85(3%) male developed PAD. Every one unit increase in log (CACs+1) was associated with 1.11-fold higher odds of incident PAD in male (p=0.001). This association remained significant after adjustment for demographics, traditional cardiovascular risk factor and baseline ABI. Male participants with CACs>300 showed 1.94-fold higher odds of incident PAD compared to participant with CACs=0 (p=0.005). In female there was no statistically significant association between CACs and incident PAD in multivariable analysis. Conclusions: Baseline CACs is associated with future PAD independent of traditional cardiovascular risk factors in male participants of a multi-ethnic cohort. Disclaimer statement: The views expressed in this abstract are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.

scholarly journals Pathophysiological Changes in Calf Muscle Predict Mobility Loss at 2-Year Follow-Up in Men and Women With Peripheral Arterial Disease

Circulation ◽  
2009 ◽  
Vol 120 (12) ◽  
pp. 1048-1055 ◽  
Author(s):  
Mary McGrae McDermott ◽  
Luigi Ferrucci ◽  
Jack Guralnik ◽  
Lu Tian ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Calf Muscle ◽  
Men And Women ◽  
Peripheral Arterial

scholarly journals Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population- A Five Years Retrospective Study

2017 ◽  
Vol 11 (2) ◽  
pp. 79-84
Author(s):  
Syed Dawood Md Taimur ◽  
Mashhud Zia Chowdhury ◽  
Md Enamul Hakim
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Positive Family History ◽  
Arterial Disease ◽  
Coronary Angiogram ◽  
Vessel Disease ◽  
Artery Disease ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown.Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between presence of PAD and severity of CAD. Material &Methods: This five years retrospective study was conducted at invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, severity of coronary artery and peripheral artery disease.Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension were detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 88.3% and 58.4% had positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients 52 had both coronary and peripheral arterial disease which was statistically significant (p<.014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. Peripheral angiogram revealed 51.9% had superficial femoral artery disease, 24.7% had anterior tibial artery disease, 26% had posterior tibial artery disease, 15.6% had common iliac artery and common femoral artery disease and 2.6% had renal artery disease.Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.University Heart Journal Vol. 11, No. 2, July 2015; 79-84

Abstract 278: Lipid Control in Patients With New Symptoms of Peripheral Arterial Disease Evaluated at Vascular Specialty Clinics

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Kim Smolderen ◽  
Jan-Willem Elshof ◽  
Moniek van Zitteren ◽  
John A Spertus ◽  
Johan Denollet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Secondary Prevention ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Initial Evaluation ◽  
Specialty Clinic ◽  
Lipid Control ◽  
Peripheral Arterial

Background: Obtaining adequate lipid control (LDL-Cholesterol [LDL] <100 mg/dL) in patients with peripheral arterial disease (PAD) is a critical, guideline-directed secondary prevention target. Current compliance with this recommendation is unknown. Methods: A total of 616 patients had their LDL levels measured at 2 vascular specialty clinics in the Netherlands (March 2006-November 2011) during the evaluation of new PAD symptoms. A year following this evaluation, 417 (68%) patients had their LDL levels re-assessed. Information about patients’ demographic and clinical factors was systematically abstracted from medical records. Categories of patients were created based on the attainment of the recommended LDL target (<100 mg/dL [on target] vs. ≥100 mg/dL [off target]). Predictors of being off target at initial evaluation and at 1-year follow-up were identified through multivariable logistic regression analyses. Results: Of the total group, 57% (351/616) were off target at initial evaluation and 81% (496/616) were on lipid-lowering drugs after the initial evaluation at the PAD specialty clinic. One year later, only 25% (103/417) got on target, while 35% (147/417) patients remained off target, and an additional 10% (43/417) saw an increase in LDL to become off target. A total of 30% (124/417) remained on target. Patients with hypertension, diabetes, a history of myocardial infarction, and a lower ankle-brachial index were less likely to be off target at initial evaluation. Predictors of being off target at 1-year follow-up were male sex, and having a higher ankle-brachial index ( Table ). Conclusion: About half of patients with PAD seen at vascular specialty clinics had above-target LDL levels both upon entry and 1 year later. Patients with existing cardiovascular risk factors were much better controlled, as compared with patients without such risk factors. Males and those with higher ankle-brachial indices were less likely to be on target 1 year following management at the specialty clinic. Reasons for poorly regulated lipids need to be further explored, and appropriate quality-of-care improvement strategies will likely be needed to optimize secondary prevention.

Abstract P247: Dietary Intake and Peripheral Arterial Disease Incidence in Middle Aged Adults: the Atherosclerosis Risk in Communities Study (ARIC)

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Rachel P Ogilvie ◽  
Pamela L Lutsey ◽  
Gerardo Heiss ◽  
Aaron R Folsom ◽  
Lyn M Steffen
Keyword(s):  
Peripheral Arterial Disease ◽  
Dietary Intake ◽  
Lower Risk ◽  
Meat Consumption ◽  
Arterial Disease ◽  
Food Groups ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is a costly source of morbidity and mortality among older persons in the United States. Dietary intake plays a role in the development of atherosclerotic cardiovascular disease; however, few studies have examined the relation of food intake or diet patterns with PAD. Objectives: We examined the relationship between habitual dietary intake at midlife and incident PAD over approximately 20 years of follow-up. Methods: Among 14,082 participants enrolled in the Atherosclerosis Risk in Communities (ARIC) study initially free of PAD, dietary intake was assessed at baseline in 1987-1989 using a Harvard food frequency questionnaire. Food groups were created and principal components analysis was used to develop “healthy” and “Western” dietary patterns; both were categorized into quintiles or quartiles. Incident PAD was defined by an ankle-brachial index (ABI) measure of < 0.90 at either of two subsequent exams (1993-1995, 1996-1998), or a hospital discharge diagnosis of PAD, leg amputation, or leg revascularization procedures through 2012. Cox proportional hazards models adjusted for relevant confounders assessed the relations of each food group or diet pattern with incident PAD. Results: During a mean follow up of 19.9 years, 1569 participants developed incident PAD. A total of 64.7% of cases had their incident event defined via ICD-9 codes, while 35.3% had incident PAD defined by ABI. In models adjusted for demographics, behaviors, and food groups, the hazard ratios for incident PAD increased across quintiles of meat consumption (Q2 vs. Q1 1.38 [95% CI 1.16, 1.64], Q3 vs. Q1 1.40 [1.18, 1.67], Q4 vs. Q1 1.47 [1.23, 1.77], Q5 vs. Q1 1.66 [1.36, 2.03], p for trend <0.001). Compared to those who drank no alcohol, those who had 1-6 drinks per week had a lower risk of incident PAD (HR=0.78 [95% CI 0.68, 0.89]). For coffee, there was a modest inverse association with incident PAD (Q5 vs. Q1 0.84 [0.75, 1.00], p for trend = 0.014). There was no association between other food groups or patterns and incident PAD. Conclusions: In this prospective population-based cohort study, greater meat consumption was associated with higher risk of incident PAD, while both moderate alcohol consumption and coffee consumption were associated with lower risk of incident PAD. Whether these associations are causal remains to be seen.

Relation between Chronic Obstructive Pulmonary Disease and Peripheral Arterial Disease among Construction Workers

2021 ◽  
Vol 15 (10) ◽  
pp. 3473-3475
Author(s):  
U. Sivakumar ◽  
Rinku Garg ◽  
Sunita Nighute
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Peripheral Arterial Disease ◽  
Pulmonary Disease ◽  
Arterial Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Death ◽  
Increased Risk ◽  
Peripheral Arterial

Introduction: PAD was asymptomatic in a large proportion of COPD patients and was associated with more severe lung disease than in COPD subjects without PAD. Materials and Methods: This was a Cross-sectional study conducted at Department of Physiology, Santosh Medical College diagnosed with COPD using Spirometry was recruited for the study with a Sample size of 130 patients. Results: The characteristics of the population for follow-up (n=130) are presented in table 1. The mean Mean±SD was 51.73±6.1 years. The prevalence of never smokers was 21.5%, former smokers were 51.5% and current smokers were 26.9%. In total, 41 out of 130 individuals (31.5%) had PAD based on an ABI of less than 0.6. A statistically significant association was found between COPD and newly diagnosed PAD during follow-up. The association between COPD and incident PAD was stronger (adjusted OR 1.91, 95% CI 1.14–3.21). Stratified analysis by smoking status revealed that the overall association between COPD and newly developed PAD was driven by the ever smoker group. Conclusion: Subjects with COPD have a higher risk of developing PAD. People with both COPD and PAD have a substantially increased risk of death. Consequently, early detection of PAD and preventive actions in people with COPD should receive more attention in clinical respiratory care. Keywords: Peripheral Arterial Disease, Chronic Obstructive Pulmonary Disease, Ankle-brachial index.

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