scholarly journals Lower extremity and carotid artery disease in COPD

2016 ◽  
Vol 2 (4) ◽  
pp. 00037-2016 ◽  
Author(s):  
Carmen Pizarro ◽  
Fabian Linnhoff ◽  
Fabian van Essen ◽  
Simon Pingel ◽  
Christian Alexander Schaefer ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Odds Ratio ◽  
Carotid Artery Disease ◽  
Plaque Burden ◽  
Chronic Obstructive ◽  
Peripheral Artery ◽  
Copd Patients ◽  
Artery Disease

In view of their common chronic inflammatory process, we sought to determine the linkage between peripheral artery disease and chronic obstructive pulmonary disease (COPD).107 COPD patients (mean±sdage 64.6±10.4 years, 52.2% male) and 22 control smokers without previously diagnosed peripheral artery disease underwent standardised angiological examination for lower extremity artery disease (LEAD) and carotid artery disease.LEAD was significantly more prevalent in COPD patients than in controls (80.4%versus54.5%, p=0.002). Among COPD patients, 57.0%, 12.2%, 10.3% and 0.9% were found to be in Fontaine stages I, IIA, IIB and III, respectively. As with carotid artery disease, its frequency increased from 36.4% in controls to 58.9% in COPD patients (p=0.003). Carotid plaque burden, LEAD Fontaine degrees as well as pulse wave index and ankle–brachial index manifested significant impairment over percentage predicted forced expiratory volume in 1 s (FEV1% pred) (p=0.02, p<0.001, p=0.01 and p<0.001, respectively). Multivariate analysis revealed that COPD Global Initiative for Chronic Obstructive Lung Disease status was the strongest independent predictor for the presence of plaque in lower extremity arteries (odds ratio 1.63, 95% CI 1.19–2.25, p=0.003) and carotids (odds ratio 1.66, 95% CI 1.14–2.44, p=0.009).As compared with control smokers, peripheral artery disease is diagnosed in a sizeable proportion of COPD patients and exhibits significant distributive differences over FEV1% pred that exceed the susceptibility conferred by common cardiovascular stressors.

scholarly journals Cost-effectiveness of low-dose rivaroxaban and aspirin versus aspirin alone in people with peripheral or carotid artery disease: An Australian healthcare perspective

2018 ◽  
Vol 26 (8) ◽  
pp. 858-868 ◽  
Author(s):  
Ella Zomer ◽  
Si Si ◽  
Thomas R Hird ◽  
Danny Liew ◽  
Alice J Owen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
At Risk ◽  
Cost Effectiveness ◽  
Carotid Artery ◽  
Peripheral Artery Disease ◽  
Carotid Artery Disease ◽  
Aspirin Therapy ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Quality Adjusted Life

Aims Peripheral artery disease affects 1.2% of the population globally and is associated with an increased risk of atherothrombotic cardiovascular events, major adverse limb events and mortality. The Cardiovascular Outcomes for People Using Anti-coagulation Strategies (COMPASS) trial demonstrated positive results of rivaroxaban plus aspirin therapy compared to aspirin therapy alone in those with peripheral artery disease or carotid artery disease. We sought to estimate the cost-effectiveness from the Australian healthcare system perspective. Methods and results A Markov model was developed to simulate the experiences of a hypothetical population of 1000 individuals with peripheral artery disease or carotid artery disease, profiled on the COMPASS trial, treated with rivaroxaban plus aspirin therapy versus aspirin therapy alone. With each annual cycle, individuals were at risk of having non-fatal cardiovascular disease events, major adverse limb events, or dying. Individuals were also at risk of non-fatal major bleeding. The model had a lifetime time horizon. Costs and utilities were sourced from the literature and discounted at 5.0% annually. Rivaroxaban plus aspirin therapy prevented 143 non-fatal cardiovascular disease events, 118 major adverse limb events and 10 deaths compared to aspirin therapy alone. Conversely, 156 additional major non-fatal bleeds were accrued. With an additional 256 quality-adjusted life years gained, at an additional cost of AUD$6,858,103, the incremental cost-effectiveness ratio was AUD$26,769 (discounted) per quality-adjusted life year gained, which is below Australia’s arbitrary willingness to pay threshold of AUD$50,000. Conclusion In those with peripheral artery disease or carotid artery disease, rivaroxaban plus aspirin therapy is effective and cost-effective in the prevention of recurrent cardiovascular disease compared to aspirin therapy alone.

scholarly journals Relationship Between Risk Factors and Carotid Artery Stenosis Prevalence in Patients With Lower Extremity Peripheral Arterial Disease

2020 ◽  
Vol 1 (2) ◽  
pp. 21-25
Author(s):  
Dedy Pratama ◽  
Haidir Bima ◽  
Aria Kekalih ◽  
Raden Suhartono
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Smoking History ◽  
Peripheral Artery ◽  
Media Thickness ◽  
Artery Disease

Introduction: One of degenerative disease is atherosclerosis. Peripheral artery disease (PAD) and carotid artery stenosis (CS) broadly covers vascular disease, both of which can be caused by atherosclerosis. Given the general etiology of peripheral atherosclerosis that can occur in different vascular locations, the presence of disease in one place increases the frequency of symptomatic and asymptomatic disease in another. Because both have the same cause, there is a hypothesis that the two are correlated. The purpose of this study was to determine the risk factors associated with carotid artery stenosis (CS) in patients with lower extremity peripheral artery disease (PAD) and to determine the prevalence of carotid artery stenosis (CS) and the thickness of intimal media thickness (IMT) in patients with lower extremity peripheral artery disease (PAD). Method: This research was conducted at Cipto Mangunkusumo General Hospital during February-May 2018. This study was prospective. Data were taken from secondary data based on history and laboratory results, while the degree of stenosis and intimal media thickness were carried out by carotid duplex ultrasound (DUS) with united imaging ultrasound using a probe 8.5 Mhz. The receiver operating characteristic curve was used to assess the best cut point with sensitivity, specificity, positive predictive value, and negative predictive value. Results: A total of 50 subjects with an age range between 49-80 years (63.8 ± 8.8 years), of which there were 31 male males (62%) and 19 females (38%). There was a correlation between hypercholesterolemia and smoking history with the degree of carotid stenosis (p <0.05), while risk factors for the degree of IMT was not found. The prevalence of mild carotid artery stenosis (CS) was 26 (52%), moderate carotid artery stenosis 15 (30%), severe carotid artery stenosis 9 (18%). In comparison, the IMT value in this study obtained 9 (18%) mild IMT, 22 (44%) moderate IMT, and 19 (38%) severe IMT. Conclusion: In patients with severe PAD, the highest incidence of carotid artery stenosis (CS) was in the mild category (52%). The highest rate of intimal media thickness (IMT) was a medium-size IMT (44%). Carotid artery stenosis (CS) was associated with hypertension, diabetes, hypercholesterolemia, smoking, and a family history of atherosclerosis. In statistical analysis, hypercholesterolemia and smoking history had a relationship with the severity of carotid stenosis. Keywords: Atherosclerosis, carotid artery stenosis (CS), carotid duplex ultrasound (DUS), intimal media thickness (IMT), peripheral arterial disease (PAD)

scholarly journals PERIPHERAL ARTERY DISEASE, SYMPTOMS AND CAROTID ARTERY DISEASE

2012 ◽  
Vol 59 (13) ◽  
pp. E2104 ◽  
Author(s):  
Louai Razzouk ◽  
Caron Rockman ◽  
Manesh Patel ◽  
Mark Adelman ◽  
Thomas Riles ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Peripheral Artery Disease ◽  
Carotid Artery Disease ◽  
Peripheral Artery ◽  
Disease Symptoms ◽  
Artery Disease

Relationship of triglyceride–glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease

Vascular ◽  
2021 ◽  
pp. 170853812110183
Author(s):  
Arda Aybars Pala ◽  
Yusuf Salim Urcun
Keyword(s):  
Lower Extremity ◽  
High Density Lipoprotein ◽  
Peripheral Artery Disease ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Objectives Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development. Methods A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as “Group 1” ( n = 224) and those who developed were classified as “Group 2” ( n = 72). Results The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092–1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715–0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050–16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume. Conclusions Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.

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