scholarly journals Angiotensin-Converting Enzyme Genotype and Peripheral Arterial Disease in Diabetic Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Chin-Hsiao Tseng ◽  
Farn-Hsuan Tseng ◽  
Choon-Khim Chong ◽  
Ching-Ping Tseng ◽  
Ju-Chien Cheng
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Angiotensin Converting Enzyme ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Converting Enzyme ◽  
Odds Ratios ◽  
Traditional Risk Factors ◽  
Peripheral Arterial

We investigated the effect of traditional risk factors (hypertension, dyslipidemia and smoking) on the association between angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and peripheral arterial disease (PAD) in 945 (454 men and 491 women) Taiwanese type 2 diabetic patients with a mean age of 63.5 (SD: 11.4) years. Among them, 81 (31 men and 50 women) had PAD (ankle-brachial index <0.9). The adjusted odds ratios (95% confidence intervals) were 2.48 (1.18–5.21), 1.69 (1.00–2.85) and 1.64 (1.12–2.39), respectively, for recessive (DD versus II + ID), dominant (DD + ID versus II) and additive (II = 0, ID = 1 and DD = 2) models. While analyzing the interaction between DD and the individual risk factor of hypertension, smoking and dyslipidemia, patients with the risk factor and with DD had the highest risk compared to referent patients without the risk factor and with II/ID. The respective adjusted odds ratios were 5.41 (2.05–14.31), 7.38 (1.87–29.06) and 4.64 (1.70–12.64). We did not find a significant interaction between DD and any of the risk factors under multiplicative or additive scale. In conclusion, traditional risk factors (hypertension, smoking and dyslipidemia) play an important role in the association between ACE genotypes and PAD. Patients with DD genotype and traditional risk factors are at the highest risk.

The angiotensin-converting-enzyme insertion/deletion polymorphism is not a risk factor for peripheral arterial disease

2002 ◽  
Vol 165 (1) ◽  
pp. 175-178 ◽  
Author(s):  
Wilfried Renner ◽  
Edmund Pabst ◽  
Bernhard Paulweber ◽  
L Malaimare ◽  
B Iglseder ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Angiotensin Converting Enzyme ◽  
Arterial Disease ◽  
Converting Enzyme ◽  
Deletion Polymorphism ◽  
Peripheral Arterial

scholarly journals Is There a Risk Factor More Responsible for Disaster?

2015 ◽  
Vol 61 (3) ◽  
pp. 245-247
Author(s):  
Carasca Cosmin ◽  
Muresan Vasile Adrian ◽  
Tilea Ioan ◽  
Magdas Annamaria ◽  
Carasca Emilian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Risk Level ◽  
Critical Ischemia ◽  
Medium Risk ◽  
Peripheral Arterial

Abstract Background: Risk factors for peripheral arterial disease are generally the same as those responsible for the ischemic heart disease and in both cases are overlapping risk factors involved in the etiology of atherosclerosis, such as smoking, dyslipidemia, diabetes and hypertension. Case report: We present a case of a 61 years old male, whose ischemic peripheral symptoms began in 2003, at the age of 49, presenting as a Leriche syndrome. The patient was subjected to first revascularization procedure consisting in aortic-bifemoral grafting in the same year. General examination revealed no risk factors except smoking. Only a year after, he returns with critical right lower limb ischemia due to bypass thrombosis, therefore two thrombectomies were performed followed by a right side femoro-popliteal bypassing with Dacron prosthesis. The patient’s condition was good until 2008 when a femoro-popliteal bypass using inverted autologus saphenous vein was imposed due to occlusion of the previous graft. In 2013 the patient was readmitted to hospital with left lower limb critical ischemia. A femoro-popliteal bypass was performed, followed by two thrombectomies and the amputation of the left thigh. Up to this date, the patient kept smoking. Discussions: Although our patient has a low/medium risk level of atherosclerosis by Framingham score and a minimum Prevent III score, all the surgical revascularization procedures were not able to avoid the amputation. Conclusions: There are enough reasons to believe that smoking as a single risk factor can strongly influence the unfavorable progression to amputation in patients with peripheral arterial disease.

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