Peripheral artery disease assessed by ankle-brachial index in patients with established cardiovascular disease or at least one risk factor for atherothrombosis - CAREFUL Study: A national, multi-center, cross-sectional observational study

We evaluated angiogenin as a prospective biomarker in peripheral artery disease (PAD) patients with and without claudication symptoms. A pilot study suggested an elevation of angiogenin in critical limb ischemia. However, in PAD patients, the predictive value of angiogenin has not yet been evaluated. For this purpose, 342 patients with PAD (age: 69 ± 10 years, 34.5% women) were followed-up for 7 years in a cross-sectional study. Angiogenin was measured by enzyme-linked immunosorbent assay. All-cause and cardiovascular mortality were analyzed by Cox regression. Angiogenin levels were higher in men ( P = .001) and were associated with patient waist-to-hip ratio ( P < .001), fasting triglycerides ( P = .011), and inversely with estimated glomerular filtration rate ( P = .009). However, angiogenin showed no association with age, characteristics of diabetes, markers of lipid metabolism, or C-reactive protein. Angiogenin did not correlate with markers of angiogenesis such as vascular endothelial growth factor, angiopoietin-2, or tie-2. Furthermore, angiogenin was not associated with PAD Fontaine stages or with patient ankle-brachial index in addition to all-cause mortality (hazard ratio [HR] = 1.09 [95% CI: 0.89-1.34]) or cardiovascular morality (HR = 1.05 [0.82-1.35]). These results suggest that angiogenin does not provide further information regarding outcome prediction in patients with PAD.

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Association between AST to ALT ratio and peripheral artery disease in Chinese adults with hypertension：a cross-sectional study

10.21203/rs.3.rs-109730/v1 ◽

2020 ◽

Author(s):

Hui Liu ◽

Xiaoyuan Zha ◽

Congcong Ding ◽

Lihua Hu ◽

Minghui Li ◽

...

Keyword(s):

Cardiovascular Disease ◽

Peripheral Artery Disease ◽

Reference Group ◽

Final Analysis ◽

Multivariate Logistic Regression Model ◽

Peripheral Artery ◽

Chinese Adults ◽

Cross Sectional ◽

Increased Risk ◽

Artery Disease

Abstract Background: Previous studies had shown that aspartate aminotransferase to alanine aminotransferase (AST/ALT ratio) plays a role in cardiovascular disease. Peripheral artery disease (PAD) is an important risk factor for cardiovascular disease. However, there are a little research on the association between the AST/ALT ratio and Peripheral artery disease (PAD). Methods: A total of 10, 900 hypertensive patients from the Chinese Hypertension Registry Study were included in the final analysis. The association between AST / ALT and peripheral arterial disease (PAD), which was defined as ABI ≤ 0.9 in either leg, was estimated by a multivariate logistic regression model.Results: Overall, the prevalence of PAD was 3.21%. After adjusting for potential confounders, AST / ALT ratio was independently and positively associated with the risk of PAD (OR: 1.31, 95% CI: 1.13 to 1.59), and a statistically significant increased risk of PAD for the third tertile (T3) of AST / ALT ratio compared to the first tertile (T1) (OR:1.49, 95% CI: 1.09 to 2.04, P-trend= 0.005) was found. Moreover, when the T1-T2 group was combined into one group and used it as a reference group, the risk of PAD increased with the increase of AST/ALT and the risk ratio was 1.52 (95% CI :1.20 to 1.95). Conclusion: A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. The presented results suggested that AST / ALT may help us highlight patients who are at high risk of vascular endpoints.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.

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The risk of peripheral artery disease in older adults - seven-year results of the getABI study

VASA ◽

10.1024/0301-1526/a000556 ◽

2016 ◽

Vol 45 (5) ◽

pp. 403-410 ◽

Cited By ~ 9

Author(s):

Dietmar Krause ◽

Ina Burghaus ◽

Ulrich Thiem ◽

Ulrike S. Trampisch ◽

Matthias Trampisch ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Risk Factor ◽

Peripheral Artery Disease ◽

Ankle Brachial Index ◽

Density Lipoprotein ◽

Current Smoker ◽

Repeated Measurements ◽

Peripheral Artery ◽

Artery Disease

Abstract. Background: To assess the risk of peripheral artery disease (PAD) in older adults and the contribution of traditional and novel risk factors to the incidence of PAD. Patients and methods: 344 general practitioners (GPs), trained by vascular specialists all over Germany, enrolled 6,880 unselected participants aged 65 years or older (getABI study). The onset of PAD was determined by a regression method in the course of repeated measurements of the ankle brachial index (ABI) over seven years. PAD onset was defined by the declining linear regression ABI line reaching 0.9 or by PAD symptoms. Results: The cumulative PAD incidence over seven years was 12.9%, corresponding to an incidence rate of 20.3 per 1000 person years (95% confidence interval [95%CI] 18.8 to 21.7). Logistic regression analysis showed that traditional risk factors contributed significantly to the risk of PAD: current smoker status (odds ratio 2.65, 95%CI 2.08 to 3.37), diabetes (1.35, 95%CI 1.13 to 1.62), and low-density lipoprotein >130 mg/dl (1.26, 95%CI 1.07 to 1.48). Three novel risk factor candidates showed significant impact on PAD incidence: elevated sensitive C-reactive protein level (1.23, 95%CI 1.05 to 1.45), impaired estimated glomerular filtration rate (1.27, 95%CI 1.03 to 1.56), and elevated homocysteine level (1.19, 95%CI 1.01 to 1.41). Conclusions: Older adults in Germany have a PAD risk of 12.9% per seven years. Potentially modifiable traditional PAD risk factors yield high impact on PAD incidence. Novel risk factor candidates may contribute to the risk of PAD

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Association Between AST To ALT Ratio And Peripheral Artery Disease In Chinese Adults With Hypertension: A Cross-Sectional Study

10.21203/rs.3.rs-131080/v1 ◽

2020 ◽

Author(s):

Hui Liu ◽

Xiaoyuan Zha ◽

Congcong Ding ◽

Lihua Hu ◽

Minghui Li ◽

...

Keyword(s):

Cardiovascular Disease ◽

Peripheral Artery Disease ◽

Reference Group ◽

Final Analysis ◽

Multivariate Logistic Regression Model ◽

Peripheral Artery ◽

Chinese Adults ◽

Cross Sectional ◽

Increased Risk ◽

Artery Disease

Abstract Background: Previous studies had shown that aspartate aminotransferase to alanine aminotransferase (AST/ALT ratio) plays a role in cardiovascular disease. Peripheral artery disease (PAD) is an important risk factor for cardiovascular disease. However, there are a little research on the association between the AST/ALT ratio and Peripheral artery disease (PAD). Methods: A total of 10, 900 hypertensive patients from the Chinese Hypertension Registry Study were included in the final analysis. The association between AST / ALT and peripheral arterial disease (PAD), which was defined as ABI ≤ 0.9 in either leg, was estimated by a multivariate logistic regression model.Results: Overall, the prevalence of PAD was 3.21%. After adjusting for potential confounders, AST / ALT ratio was independently and positively associated with the risk of PAD (OR: 1.31, 95% CI: 1.13 to 1.59), and a statistically significant increased risk of PAD for the third tertile (T3) of AST / ALT ratio compared to the first tertile (T1) (OR:1.49, 95% CI: 1.09 to 2.04, P-trend= 0.005) was found. Moreover, when the T1-T2 group was combined into one group and used it as a reference group, the risk of PAD increased with the increase of AST/ALT and the risk ratio was 1.52 (95% CI :1.20 to 1.95). Conclusion: A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. The presented results suggested that AST / ALT may help us highlight patients who are at high risk of vascular endpoints.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.

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Abstract 508: Peripheral Artery Disease is Associated With Frailty in Patients With Chorionic Hemodialysis

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.37.suppl_1.508 ◽

2017 ◽

Vol 37 (suppl_1) ◽

Author(s):

Hidemi Takeuchi ◽

Michihiro Okuyama ◽

Haruhito A Uchida ◽

Nozomu Otaka ◽

Yuki Kakio ◽

...

Keyword(s):

Peripheral Artery Disease ◽

Ankle Brachial Index ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Vascular Complication ◽

Chronic Hemodialysis ◽

Peripheral Artery ◽

Frailty Phenotype ◽

Cross Sectional ◽

Artery Disease

Objective: The clinical condition of frailty is a common problem in the elderly population. Chronic hemodialysis (HD) patients often have peripheral artery disease (PAD) as a vascular complication. However, the relationship between PAD and frailty in Japanese HD patients remains unknown. The aim of this study was to identify the relationships among PAD and risk factors in Japanese chronic HD patients. Method: This study was a multi-center, cross-sectional and observational investigation which was conducted at 6 institutions, including 5 general hospitals and 1 private clinic. Subjects were all chronic HD patients who regularly visited the institutions. To evaluate frailty, we used the modified Fried’s frailty phenotype adjusted for Japanese as the self-reported questionnaire, and measured each physical domain. Furthermore, we calculated ankle-brachial index (ABI) to define PAD. PAD was defined as ABI < 0.9 in our study. Result: Of the 542 patients in all institutions, 362 were enrolled in this study. Sixty-two patients (17.1%) were categorized as PAD group and 300 patients (82.9%) as non-PAD group. In the PAD group, the prevalence of frailty was significantly higher than in the non-PAD group (34% vs 18%). Non-shunt side grip strength was significantly stronger in the non-PAD group (23.6 kg vs 17.0 kg, P <0.0001). Thigh circumferences (the mean of both sides) were also significantly larger in the non-PAD group (41.7 cm vs 39.7 cm, P =0.0054). Univariate regression analyses showed that frailty, age, number of oral medicine, and history of myocardial infarction (MI) had significant correlations with PAD. Multivariate logistic regression analysis demonstrated that the factors independently associated with PAD were as follows: frailty (OR = 2.061, 95% C.I. 1.091-3.894) and MI (OR = 3.742, 95% C.I. 2.051-6.831). Conclusion: PAD is associated with frailty in HD patients.

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AST/ALT Ratio and Peripheral Artery Disease in a Chinese Hypertensive Population: A Cross-Sectional Study

Angiology ◽

10.1177/00033197211004410 ◽

2021 ◽

pp. 000331972110044

Author(s):

Hui Liu ◽

Xiaoyuan Zha ◽

Congcong Ding ◽

Lihua Hu ◽

Minghui Li ◽

...

Keyword(s):

Risk Factor ◽

Peripheral Artery Disease ◽

Reference Group ◽

Cardiovascular Death ◽

Cross Sectional Study ◽

Peripheral Artery ◽

Chinese Adults ◽

Cross Sectional ◽

Increased Risk ◽

Artery Disease

Previous studies reported that the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) was a risk factor in cardiovascular disease. Peripheral artery disease (PAD) is an important risk factor for cardiovascular death. However, only a few studies investigated the correlations between the AST/ALT ratio and PAD. We analyzed data from 10 900 patients with hypertension from the Chinese Hypertension Registry Study; 350 patients had PAD (prevalence 3.2%). After adjusting for potential confounders, the AST/ALT ratio was independently and positively associated with risk of PAD (OR: 1.31, 95% CI, 1.13-1.59), and a significant increased risk of PAD for the third AST/ALT ratio tertile (T3) compared with the first tertile (T1; OR: 1.49, 95% CI, 1.09-2.04, P trend = .005) was found. Moreover, when we combined T1 and T2 into one group and used it as a reference group, the risk of PAD increased with the increase in AST/ALT; the risk ratio was 1.52 (95% CI, 1.20-1.95). A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. Our results suggest that the AST/ALT ratio may help identify patients at high risk of vascular end points and might be a convenient, economical, and effective tool for evaluating the risk of atherosclerosis.

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O72: SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE IN PERIPHERAL ARTERY DISEASE PATIENTS

British Journal of Surgery ◽

10.1093/bjs/znab117.072 ◽

2021 ◽

Vol 108 (Supplement_1) ◽

Author(s):

ST Rashid ◽

S Bangee

Keyword(s):

Cardiovascular Disease ◽

Risk Factor ◽

Secondary Prevention ◽

Peripheral Artery Disease ◽

Peripheral Artery ◽

Nice Guidelines ◽

Novel Treatments ◽

Wide Range ◽

Artery Disease ◽

Prevention Of Cardiovascular Disease

Abstract Introduction Peripheral artery disease (PAD) is associated with significant cardiovascular morbidity and mortality which can be reduced by the treatment of atherosclerotic risk factors. Recent research demonstrates that novel drugs can significantly enhance PAD outcomes. However, the uptake of these drugs is uncertain. We wished to audit current atherosclerotic management in PAD patients as well as their eligibility for newer drugs - PCSK 9 inhibitors, SGLT2 inhibitors, and DOAC drugs – in accordance with relevant guidelines and trials. Method 100 PAD inpatients and outpatients seen at a teaching hospital in the UK within the month of March 2019 were assessed. Medications from PAD patients were recorded from hospital records and patient histories were assessed for secondary prevention of cardiovascular disease - lipids, blood pressure, diabetic control, and atherothrombotic prevention. Result showed that compliance with NICE guidelines had a wide range – from 19% of outpatients on correct lipid control to 89% of inpatients on optimal atherothrombotic management. Based on the best evidence of eligibility: 0 of 41 eligible patients were taking PCSK9 Inhibitors, 1 out of the 71 was on an SGLT 2 inhibitor and 6 of 98 patients were on Rivaroxaban. Conclusion This audit shows adherence to NICE guidelines is variable for secondary prevention of atherosclerosis in PAD patients. Furthermore, very few novel treatments had been prescribed for suitable patients. Overall, prescribing for PAD risk factor management can be significantly improved. A solution could be dedicating risk factor clinics led by nurses, pharmacists or physicians. Take-home message Steps need to be taken to prevent cardiovascular disease in peripheral arterial disease patients. Steps include improvements in the following of guidelines, exploration of novel treatments, and the introduction of special risk factor clinics focused on improving the prognosis of the patients.

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