Peripheral artery disease: what is the best approach? The diagnostic and therapeutic algorithm for clinical practice

Background: Peripheral artery disease (PAD) is a distinct atherosclerotic disorder marked by stenosis of the arteries common in tobacco users. Here we investigate prediction of unknown peripheral arterial disease (PAD) amongst patients with diabetic tobacco user and diabetic without tobacco user.Methodology: This prospective observational study was conducted in the Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh. A total of 60 patients were enrolled in this study who were presented with chest pain associated with lower limb claudication. They were diabetic population, constituted tobacco user in group-I and without tobacco user in group-II.Results: Hypertension was the leading risk factor in both groups (76.7% vs. 80%). 80% of patients of group I and 46.7% of patients of group II had mild form of ABI value. 3.3% of patient of group II had severe form of ABI value. There was no statistical significant difference between two group of patients (p=0.053). 93.3% patients of group I and 96.7% patients of group II had coronary artery disease. Twenty three patients of tobacco user group (n=30) had peripheral artery disease, whereas ten patients of without tobacco user group (n=30) had peripheral artery disease which was statistically significant (p=0.003). Three quarters (76.7%) of group I developed PVD as compared to 33.3% of group II. The risk of developing PVD in diabetic smokers was observed to be more than 6 fold (95% CI: 2.109-20.479) higher than that in non tobacco user were diabetics. 16.7% patients of group I atherosclerosis in femoral artery and the value is 10% in case of group-II, which is statistically in significant(p=0.433).Conclusion: The awareness and implementation of ABI in general clinical practice is poor. A simple, inexpensive test like ABI can improve the diagnosis of PAD in clinical practice and thus help in preventing CAD and consequent death by a range of medical therapies.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 102-109

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Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association

Circulation ◽

10.1161/cir.0000000000001005 ◽

2021 ◽

Author(s):

Michael H. Criqui ◽

Kunihiro Matsushita ◽

Victor Aboyans ◽

Connie N. Hess ◽

Caitlin W. Hicks ◽

...

Keyword(s):

Health Care ◽

Clinical Practice ◽

Lower Extremity ◽

Peripheral Artery Disease ◽

Health Care Professionals ◽

Care Providers ◽

Peripheral Artery ◽

Scientific Statement ◽

Artery Disease ◽

Physiological Tests

Lower extremity peripheral artery disease (PAD) affects >230 million adults worldwide and is associated with increased risk of various adverse clinical outcomes (other cardiovascular diseases such as coronary heart disease and stroke and leg outcomes such as amputation). Despite its prevalence and clinical importance, PAD has been historically underappreciated by health care professionals and patients. This underappreciation seems multifactorial (eg, limited availability of the first-line diagnostic test, the ankle-brachial index, in clinics; incorrect perceptions that a leg vascular disease is not fatal and that the diagnosis of PAD would not necessarily change clinical practice). In the past several years, a body of evidence has indicated that these perceptions are incorrect. Several studies have consistently demonstrated that many patients with PAD are not receiving evidence-based therapies. Thus, this scientific statement provides an update for health care professionals regarding contemporary epidemiology (eg, prevalence, temporal trends, risk factors, and complications) of PAD, the present status of diagnosis (physiological tests and imaging modalities), and the major gaps in the management of PAD (eg, medications, exercise therapy, and revascularization). The statement also lists key gaps in research, clinical practice, and implementation related to PAD. Orchestrated efforts among different parties (eg, health care providers, researchers, expert organizations, and health care organizations) will be needed to increase the awareness and understanding of PAD and improve the diagnostic approaches, management, and prognosis of PAD.

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Associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm – a grin without a cat!

VASA ◽

10.1024/0301-1526/a000606 ◽

2017 ◽

Vol 46 (3) ◽

pp. 151-158 ◽

Cited By ~ 4

Author(s):

Hisato Takagi ◽

Takuya Umemoto

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Peripheral Artery Disease ◽

Literature Search ◽

Systematic Literature Search ◽

Peripheral Artery ◽

Epidemiological Evidence ◽

Abdominal Aortic ◽

Artery Disease ◽

Meta Analyses

Abstract. Both coronary and peripheral artery disease are representative atherosclerotic diseases, which are also known to be positively associated with presence of abdominal aortic aneurysm. It is still controversial, however, whether coronary and peripheral artery disease are positively associated with expansion and rupture as well as presence of abdominal aortic aneurysm. In the present article, we overviewed epidemiological evidence, i. e. meta-analyses, regarding the associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm through a systematic literature search. Our exhaustive search identified seven meta-analyses, which suggest that both coronary and peripheral artery disease are positively associated with presence of abdominal aortic aneurysm, may be negatively associated with expansion of abdominal aortic aneurysm, and might be unassociated with rupture of abdominal aortic aneurysm.

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