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.

scholarly journals Prevalence and predictors of peripheral arterial disease determined by ankle brachial index in diabetes population treated within primary care services in a non-urban area of lower northern Thailand

2020 ◽  
Vol 17 (6) ◽  
pp. 147916412096699
Author(s):  
Preaw Suwannasrisuk ◽  
Sarinya Sattanon ◽  
Watcharaporn Taburee ◽  
Pantitra Singkheaw ◽  
Non Sowanna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
University Hospital ◽  
Peripheral Arterial ◽  
Diabetes Patients

In diabetes patients, urban lifestyle has been concerned as one of the risk factors for peripheral arterial disease (PAD). The aims of this study were to find out the prevalence and associated risk factors of PAD in type 2 diabetes patients who live in a non-urban community area. A total of 885 participants with type 2 diabetes mellitus were enrolled from six primary care units in the health network centered at Naresuan University Hospital, Phitsanulok, between May and June 2018. Ankle-brachial index (ABI) was performed in all subjects using a vascular screening device. PAD was defined by an ABI value of 0.9 or lesser at least on one leg. The predictors of PAD were analyzed using multiple logistic regression. The prevalence of PAD was 7.2% among 884 evaluable patients. Diabetic neuropathy and a history of macrovascular complications were significant predictors of PAD.

scholarly journals Mobile educational follow-up application for patients with peripheral arterial disease

2019 ◽  
Vol 27 ◽  
Author(s):  
Cristiane Baldessar Mendez ◽  
Nádia Chiodelli Salum ◽  
Cintia Junkes ◽  
Lucia Nazareth Amante ◽  
Carlos Mauricio Lopes Mendez
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Signs And Symptoms ◽  
Arterial Disease ◽  
Pedagogical Content ◽  
Analysis And Design ◽  
Individualized Care ◽  
Technological Tool ◽  
Peripheral Arterial

ABSTRACT Objective: to describe the development of a prototype mobile educational application for nursing follow-up aimed at patients diagnosed with peripheral arterial disease. Method: a prototype-based technological production study. The construction followed the contextualized instructional design model using two steps: analysis and design and development. Results: the pedagogical content of the application was based on a survey of needs of patients with Peripheral Arterial Disease and treatments recommended in the literature. The prototype developed contained concepts, risk factors, signs and symptoms, treatment, importance of medications and their side effects, frequent doubts, necessary health care, and follow-up of patients by monitoring the evolution of the cicatricial process of lesions and possible complications, clarification of doubts and stimulus for continuation of treatment. Conclusion: the use of health applications is a technological tool with the potential to improve the follow-up of patients regarding the progress of the disease and self-care, monitoring of risk factors, co-participation of the patient in the treatment, family participation, as well as planning of individualized care, and cost reduction for the health system.

Depressive symptoms in peripheral arterial disease: A follow-up study on prevalence, stability, and risk factors

2008 ◽  
Vol 110 (1-2) ◽  
pp. 27-35 ◽  
Author(s):  
Kim G.E. Smolderen ◽  
Annelies E. Aquarius ◽  
Jolanda de Vries ◽  
Otto R.F. Smith ◽  
Jaap F. Hamming ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Follow Up Study ◽  
Peripheral Arterial

Abstract P248: Oxidized Phospholipids and Risk of Peripheral Arterial Disease in Men

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monica L Bertoia ◽  
Jennifer K Pai ◽  
Sotirios Tsimikas ◽  
Michel M Joosten ◽  
Murray A Mittleman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Conditional Logistic Regression ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Population Based ◽  
Oxidized Phospholipids ◽  
Blood Draw ◽  
Peripheral Arterial ◽  
Conventional Risk Factors

Background: Peripheral arterial disease (PAD) is highly prevalent, found in 25% of adults ≥70 years, but its risk factors are less well studied than coronary and carotid atherosclerosis. Proinflammatory oxidized phospholipids (OxPL) are a novel cardiovascular risk factor produced by oxidative stress and are preferentially bound and transported by lipoprotein (a) [Lp(a)] in plasma. Previous studies have shown an association between OxPL on apolipoprotein B-100 (OxPL/apoB) and carotid and femoral atherosclerosis. However, no previous studies have specifically examined the prospective association between OxPL/apoB and risk of PAD in a population-based cohort. Methods: We conducted a nested case-control study among men free of cardiovascular disease within the Health Professionals Follow-up Study (1994–2008) including 143 men with PAD and 429 controls matched on age, month of blood draw, and smoking. OxPL/apoB and Lp(a) were measured in stored baseline plasma. We identified cases of clinically significant PAD based on at least one of the following: (1) amputation, bypass, or other revascularization procedure for occlusive arterial disease, (2) angiogram/ultrasound confirming at least 50% stenosis of at least one artery with congruent symptoms in the ipsilateral limb, (3) ankle-brachial index < 0.9, or (4) physician's diagnosis. We used conditional logistic regression to estimate odds ratios (OR) for PAD according to level of OxPL/apoB. Results: The OR for PAD was 1.24 (95% CI 1.05–1.46) for each 1-standard deviation (SD) increase in OxPL/apoB after adjusting for matching factors. Additional adjustment for family history of MI, triglycerides, HDL-C, LDL-C, C-reactive protein, hemoglobin A1c, pack-years of smoking, physical activity, hypertension, diabetes, hypercholesterolemia, body-mass index, and aspirin use did not change this estimate: 1.24 (95% CI 1.00–1.54). OxPL/apoB was not correlated with any conventional risk factors: Spearman correlation coefficients ranged from 0.0 to 0.13. We observed no interaction with age or LDL-C. Similarly, the OR for PAD was 1.25 (95% CI 0.95–1.63) for each 1- SD increase in ln[Lp(a)] after adjusting for all of the above covariates. Conclusion: OxPL/apoB is positively associated with risk of PAD in men with no appreciable attenuation after adjustment for conventional risk factors.

Abstract P251: The Impact of Clinical Risk Factors on Risk of Peripheral Arterial Disease in Men

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Michel M Joosten ◽  
Jennifer K Pai ◽  
Eric B Rimm ◽  
Donna Spiegelman ◽  
Murray A Mittleman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Clinical Risk Factors ◽  
Individual Risk ◽  
Clinical Risk ◽  
Hazard Ratios ◽  
History Of ◽  
Peripheral Arterial

Background: Previous studies have examined individual risk factors in relation to peripheral arterial disease (PAD) but the combined effects of these factors are largely unknown. We investigated the degree to which clinical risk factors may explain the risk of PAD among men. Methods: We prospectively followed 45,596 men from the Health Professional Follow-up Study without a history of cardiovascular disease at baseline during a 22-year period (1986–2008). We defined four clinical risk factors - smoking, history of type 2 diabetes, hypertension, and hypercholesterolemia - that were updated biennially during follow-up. Cox proportional hazard models were used to compare PAD risk across individual and joint risk factors. Results: During 874,769 person-years of follow-up, 497 confirmed PAD cases occurred. All four clinical risk factors were significantly and independently associated with a higher risk of PAD after multivariate adjustment (Figure). Risk of PAD more than doubled (hazard ratio: 2.14; 95% confidence interval [95% CI]: 1.95–2.35) for each additional risk factor compared with the group free of risk factors. Men without any of the four risk factors had a relative risk of PAD of 0.19 compared with all other men (95% CI: 0.11–0.31). In 96.8% (95% CI: 95.2–98.3%) of the PAD cases, at least one of the four risk factors was present. Overall, 8 out of 10 cases of PAD appeared to be attributable to these four conventional risk factors. Conclusion: The great majority of PAD can be explained by four conventional risk factors. Figure legend: Hazard ratios for incident peripheral arterial disease (PAD) according to individual and joint risk factors. Hazard ratios are adjusted for age, height, aspirin use, family history of myocardial infarction before age 60 y, geographical region, body mass index, physical activity, alcohol consumption (and each of the other three binary clinical risk factors in the individual risk factor analyses).

Peripheral Arterial Disease in Systemic Lupus Erythematosus: Prevalence and Risk Factors

2014 ◽  
Vol 41 (2) ◽  
pp. 310-317 ◽  
Author(s):  
Jose Gabriel Erdozain ◽  
Irama Villar ◽  
Javier Nieto ◽  
Guillermo Ruiz-Irastorza
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Peripheral Arterial Disease ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Ankle Brachial Index ◽  
Vascular Risk Factor ◽  
Arterial Disease ◽  
Systemic Lupus ◽  
Peripheral Arterial

Objective.To analyze the prevalence of peripheral arterial disease (PAD) and cardiovascular (CV) risk factors in a cohort of patients with systemic lupus erythematosus (SLE) and to identify variables potentially related to PAD.Methods.The study included 216 patients with SLE from the Lupus-Cruces prospective observational cohort. The ankle brachial index (ABI) was determined in each patient, with values < 0.9 considered diagnostic of PAD. Demographic and clinical variables, presence of traditional risk factors and CV events, cardiovascular risk calculated by Systematic Coronary Risk Evaluation (SCORE), and treatments received by each patient were analyzed.Results.Ninety-two percent of patients were women. The mean age (SD) was 49 years (15), with a mean followup (SD) of 12 years (9). The prevalence of low ABI was 21%. CV risk factors were frequent: smoking, 30% of patients; high blood pressure, 32.7%; diabetes mellitus, 3.2%; hypercholesterolemia, 34.1%; and metabolic syndrome, 9.7%. The following variables were associated with low ABI in the univariate analysis: age (p < 0.001), hypertension (p = 0.002), diabetes (p = 0.018), hypercholesterolemia (p = 0.018), CV events (p < 0.001), SCORE (p = 0.004), cumulative dose of cyclophosphamide (p = 0.03), and fibrinogen levels (p = 0.002). In the multivariate analysis, the only independent variable in the final model was age (OR 1.04, 95% CI 1.02–1.07, p < 0.001), with a tendency for the presence of any vascular risk factor (diabetes, hypertension, hypercholesterolemia, or current smoking; OR 2.3, 95% CI 0.99–5.1, p = 0.053).Conclusion.The prevalence of low ABI in patients with SLE is higher than expected. While the association with CV risk factors and vascular disease in other territories was strong, we could not identify SLE-specific variables independently associated with PAD.

The Prevalence and Risk Factors for Peripheral Arterial Disease in Adults Living With Human Immunodeficiency Virus

2021 ◽  
pp. 153473462110094
Author(s):  
Amaraporn Rerkasem ◽  
Patumrat Sripan ◽  
Sasinat Pongtam ◽  
Sakaewan Ounjaijean ◽  
Kanokwan Kulprachakarn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Human Immunodeficiency Virus ◽  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Hiv Diagnosis ◽  
Immunodeficiency Virus ◽  
Peripheral Arterial ◽  
Hiv 1

Adult patients with human immunodeficiency virus (HIV) appear to be at high risk of cardiovascular disease (CVD). Peripheral arterial disease (PAD) is particularly concerning as it is associated with myocardial infarction and stroke. Nevertheless, the incidence of PAD is still unknown. The authors prospectively recruited HIV-infected patients from the outpatient clinic of the Department of Internal Medicine in our center. We assessed ankle-brachial index (ABI) using the VaSera system™ (Fukuda Denshi Co., Ltd). Patients were grouped into 3 ABI levels: an ABI ≤0.90 was considered abnormal and evidence of PAD, an ABI 1.0 to 1.40 was considered normal, and 0.91 to 0.99 was considered borderline. Cardiovascular risk factors were compared across all 3 levels of ABI and were analyzed using multivariate ordinal logistic regression. Eight hundred ninety-two patients were recruited. The mean age was 42.9 ± 10.0 years and 458 (51.4%) were males. There were 704, 149, and 39 patients in the normal, borderline, and abnormal ABI groups, respectively. The latter group of 39 patients was considered to have PAD, yielding a prevalence of 4.37% (95% confidence interval [CI] 3.21-5.93). Sex ratio, age, education levels, smoking rate, body mass index (BMI), blood pressure, prevalence of comorbidities with hypertension and coronary heart disease, median triglyceride level, reduced kidney function and HIV-1 RNA undetectable ratio, duration of HIV diagnosis, and duration on antiretroviral treatment were significantly different among 3 ABI subgroups. Independent risk factors associated with PAD were being female (odds ratio [OR]: 2.86; 95% CI: 1.94-4.22), being <30 years of age (OR: 4.66; 95% CI: 2.78-7.81), being overweight (BMI 25-25.9; OR: 0.39; 95% CI: 0.20-0.76), being obese (BMI: 30; OR: 3.53; 95% CI: 1.51-8.22), having a diastolic blood pressure ≥80 mmHg (OR: 0.50; 95% CI: 0.35-0.71), and having detectable HIV-1 RNA ≥20 copies/mL (OR: 1.85; 95% CI: 1.13-3.03). In conclusion, the prevalence of PAD in HIV-infected Thais was 4.37% in infected patients on therapy attending outpatient clinics. For this population, PAD appears to be relatively poorly correlated with traditional risk factors of CVD.

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