scholarly journals High-dose atorvastatin in peripheral arterial disease (PAD): Effect on endothelial function, intima-media-thickness and local progression of PAD

2008 ◽  
Vol 99 (01) ◽  
pp. 182-189 ◽  
Author(s):  
Roger Simon ◽  
Bernd van der Loo ◽  
Tamara Kovacevic ◽  
Christiane Brockes ◽  
Valentin Rousson ◽  
...  

SummaryBeneficial effects of aggressive lipid-lowering with high-dose atorvastatin (80 mg/day) have been demonstrated in patients with coronary and cerebrovascular disease. The impact of such a therapy in patients with peripheral arterial disease (PAD) is less known so far. Here we studied the effects of high-dose atorvastatin on brachial artery endothelial function, common carotid intima-media thickness (IMT) and local progression of PAD in these patients. One hundred of 500 patients screened with documented PAD were randomly assigned to receive 80 mg of atorvastatin daily for six months or to continue on conventional medical treatment. Ninety-six percent of patients in the control group were on standard statin treatment. High resolution B-mode ultrasonography was used to study brachial artery flowmediated dilation (FMD), IMT and ankle-brachial index (ABI) at baseline and at six months. FMD and IMT at baseline and at six months were 4.1 (0.06–8.6) versus 5.0 (0.76 vs. 8.1) %, p=0.96, and 0.76 (0.66–0.82) versus 0.73 (0.63–0.81) mm, p=0.41, respectively, in the atorvastatin group, and 2.66 (-1.9 – 6.9) versus 3.65 (0.0–8.6)%, p=0.02, and 0.78 (0.71–0.90) versus 0.77 (0.70–0.90) mm, p=0.48,in the control group. ABI at baseline and at six months was not different in either group. LDL cholesterol was reduced from 2.53 (2.21–3.28) to 1.86 (1.38–2.29) mM (p<0.0001) in the atorvastatin group, whereas levels remained stable in the control group [2.38 (1.94–3.16) vs.2.33 (1.82–2.84) mM, p=0.61]. Major adverse cardiovascular events occurred in 2.1% in the atorvastatin group and 1.9% in the control group (p= 0.61). In conclusion, in this pilot trial aggressive lipid-lowering with 80 mg of atorvastatin daily for six months had no effect on brachial artery FMD in patients with PAD. IMT andABI were also similar in patients with and without high-dose atorvastatin at six months.

2016 ◽  
Vol 62 (2) ◽  
pp. 217-220
Author(s):  
Elod Nagy ◽  
Imre Zoltan Kun ◽  
Piroska Kelemen

AbstractBackground: there is an overt bias between cardiovascular morbidity and mortality in male and female patients. Research of the past decades postulated that this difference could be due to the lipid-lowering effect of male sexual-steroids, that show decreased values in cardiovascular disease.Methods: the aim of our study was to determine total serum testosterone and dehydroepiandrosterone sulfate (DHEA-S) on a peripheral arterial disease patient’s cohort (n=35), in comparison with a healthy control group, (n=23) and to establish correlations with other biological risk factors like serum lipids, C-reactive protein, plasma fibrinogen, and the ankle-brachial pressure index.Results: our results showed that total serum testosterone and DHEA-S were significantly decreased in PAD patients in comparison to the control group. We could not observe any significant correlation with the presence of critical ischemia, the levels of total cholesterol, HDL-cholesterol, triglycerides, lipoprotein (a), C-reactive protein or plasma fibrinogen.Conclusion: these results express that low androgen levels could be implicated in the pathogenesis of peripheral arterial disease, but testosterone and DHEA-S are not markers of disease severity. The elucidation of their exact role needs larger, population-based studies.


2021 ◽  
Vol 9 (10) ◽  
pp. 2428-2435
Author(s):  
Tingchao Zhang ◽  
Gaoyang Guo ◽  
Li Yang ◽  
Yunbing Wang

In this paper, an ultralow dose paclitaxel-coated balloon was developed. Benefiting from the unique design of the meglumine matrix and outer protective sheath, its therapeutic effect was comparable to those of commercial high-dose counterparts in the swine model.


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.


1997 ◽  
Vol 2 (3) ◽  
pp. 243-251 ◽  
Author(s):  
Alan T Hirsch ◽  
Diane Treat-Jacobson ◽  
Harry A Lando ◽  
Dorothy K Hatsukami

Despite the widely held belief that there are no effective medical therapies for peripheral arterial disease (PAD), current data suggest that medical therapies can effectively modify the natural history of atherosclerotic lower extremity arterial occlusive disease. The ideal medical therapy would improve claudication, forestall the onset of limb-threatening events, decrease rates of invasive interventional therapies and improve long-term patient survival. These ideal outcomes might be achieved through the use of smoking cessation interventions, including behavioral and pharmacological therapy, and the administration of antiplatelet and lipid-lowering medications in patients with PAD.


Heart ◽  
2015 ◽  
Vol 101 (5) ◽  
pp. 356-362 ◽  
Author(s):  
Robert M Stoekenbroek ◽  
S Matthijs Boekholdt ◽  
Rana Fayyad ◽  
Rachel Laskey ◽  
Matti J Tikkanen ◽  
...  

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Christine Espinola-Klein ◽  
Hans J Rupprecht ◽  
Christoph Bickel ◽  
Karl Lackner ◽  
Savvas Savvidis ◽  
...  

Background: Carotid intima-media thickness (IMT) is a marker of early atherosclerosis. Patients with peripheral arterial disease (PAD) have advanced atherosclerosis and a high cardiovascular event rate. The aim of this study was to evaluate, whether measurement of carotid IMT adds prognostic information in PAD patients. Methods: We included 165 patients (mean age 64.5 ± 9 years, 71.5% men) with PAD. In all patients IMT was measured at both common carotid arteries and the mean IMT was used for further evaluation. Carotid IMT of more than 0.9 mm was defined as thickened. After a median follow-up of 6.5 years in total 33 patients (20%) died from cardiovascular causes. Results: Mean IMT was 0.75 ± 0.19 mm and in 30 patients (18.2%) an IMT ≥ 0.9 mm could be detected. Cardiovascular mortality was significantly higher in patients with PAD and IMT ≥ 0.9 mm than in patients with IMT ≥ 0.9 mm (IMT ≥ 0.9 mm = 40.0 % versus IMT < 0.9 mm = 15.6 %; P=0.002, figure ). In a fully adjusted Cox regression analysis (adjusted for age, sex, diabetes, hypertension, high density lipoprotein cholesterol, smoking, body mass index and acute coronary syndrome) a carotid IMT ≥ 0.9 mm could not be identified as an independent predictor for cardiovascular death (Hazard Ratio (95% Confidence Interval) = 2.0 (0.9 – 4.2), P=0.09). Conclusion: Patients with PAD and a carotid IMT ≥ 0.9 mm had a higher cardiovascular mortality than patients with normal IMT. But an increased carotid IMT could not be identified as independent predictor for cardiovascular mortality. Therefore it should be discussed whether IMT measurement adds prognostic impact in patients with PAD. Survival in Accordance to Carotid IMT


Vascular ◽  
2020 ◽  
pp. 170853812094724
Author(s):  
Ufuk Turan Kursat Korkmaz ◽  
Ahmet Yuksel ◽  
Ayhan Cetinkaya ◽  
Yusuf Velioglu ◽  
Erhan Renan Ucaroglu ◽  
...  

Objective To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. Methods One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case–control study. Participants’ baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. Results Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group ( p = 0.045, p = 0.000 and p = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group ( p = 0.000, p = 0.000 and p = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. Conclusion Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.


Sign in / Sign up

Export Citation Format

Share Document