scholarly journals Fibrinogen and Atherosclerotic Cardiovascular Diseases—Review of the Literature and Clinical Studies

2021 ◽  
Vol 23 (1) ◽  
pp. 193
Author(s):  
Stanisław Surma ◽  
Maciej Banach
Keyword(s):  
Cardiovascular Diseases ◽  
Premature Death ◽  
Arterial Disease ◽  
Current Data ◽  
Point Of View ◽  
Fibrinogen Concentration ◽  
Stage Of Development ◽  
Increased Risk ◽  
Peripheral Arterial ◽  
Atherosclerotic Cardiovascular Diseases

Atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease, cerebrovascular disease, and peripheral arterial disease, represent a significant cause of premature death worldwide. Biomarkers, the evaluation of which would allow the detection of ASCVD at the earliest stage of development, are intensively sought. Moreover, from a clinical point of view, a valuable biomarker should also enable the assessment of the patient’s prognosis. It has been known for many years that the concentration of fibrinogen in plasma increases, inter alia, in patients with ASCVD. On the one hand, an increased plasma fibrinogen concentration may be the cause of the development of atherosclerotic lesions (increased risk of atherothrombosis); on the other hand, it may be a biomarker of ASCVD, as it is an acute phase protein. In addition, a number of genetic polymorphisms and post-translational modifications of fibrinogen were demonstrated that may contribute to the risk of ASCVD. This review summarizes the current data on the importance of fibrinogen as a biomarker of ASCVD, and also presents the relationship between molecular modifications of this protein in the context of ASCVD.

scholarly journals Features of Antithrombotic Therapy in Patients with Multifocal Arterial Disease

Kardiologiia ◽  
2021 ◽  
Vol 61 (3) ◽  
pp. 87-95
Author(s):  
V. G. Grachev ◽  
S. S. Vedenskaya ◽  
O. G. Smolenskaya
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Antithrombotic Therapy ◽  
Arterial Disease ◽  
Arterial Injury ◽  
Cardiovascular Complications ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Atherosclerotic Cardiovascular Diseases ◽  
Peripheral Artery Diseases

Multifocal arterial injury is common in patients with atherosclerotic cardiovascular diseases and is associated with increased risk of cardiovascular complications and death. Administration of more intensive antithrombotic therapy, particularly combinations of acetylsalicylic acid and a “vascular” dose of rivaroxaban, in patients with multifocal arterial injury is characterized by a beneficial ratio of efficiency and safety due to a pronounced decrease in the risk of cardiovascular complications. Detection of peripheral artery diseases in patients with ischemic heart disease and atherosclerotic cerebrovascular pathology makes it possible to improve the risk stratification, optimize the diagnostic tactics and clarify indications for more intensive antithrombotic therapy.

scholarly journals Co-occurrence of depressive disorders and cardiovascular diseases – selected aspects

2020 ◽  
Vol 20 (3) ◽  
pp. 183-190
Author(s):  
Magdalena Zalewska ◽  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Depressive Disorders ◽  
Healthy Lifestyle ◽  
Platelet Reactivity ◽  
Arterial Disease ◽  
Point Of View ◽  
Immune System Dysfunction ◽  
Artery Disease ◽  
Peripheral Arterial

Depressive disorders are a common problem in patients with cardiovascular diseases. They are associated with increased mortality, disability, increased healthcare expenditure and reduced quality of life. Depression occurs in 1 in 5 patients with coronary artery disease, peripheral arterial disease or heart failure. It significantly complicates the optimal management of a patient with cardiovascular disease, primarily by reducing compliance with healthy lifestyle principles and therefore reducing the effectiveness of recommended therapeutic methods. The mechanisms responsible for unfavorable prognosis in patients with cardiovascular disease and depression are associated with lifestyle factors, autonomic dysfunction, neuroendocrine disorders, inflammation, immune system dysfunction, insulin resistance and increased platelet reactivity. These mechanisms significantly interact in the regulation of both cardiovascular and central nervous system functions. Therefore, it is important to perform prompt and complete diagnosis of depression in a particular patient with cardiovascular disease, and to implement optimal therapeutic management from the psychiatric and cardiological point of view. In recent years, interest in the effect of antidepressants on cardiac parameters in patients with depression has increased. The assessment of the safety and efficacy of antidepressant therapy in the treatment of cardiac patients with depression is also important due to the fact that depression in these patients is often accompanied by other significant comorbidities such as diabetes, hypertension and tobacco addiction. The aim of this study was to review the most important aspects necessary in the cooperation of a psychiatrist and cardiologist that may enable the most effective treatment of patients with depressive disorders coexisting with selected cardiovascular diseases.

scholarly journals What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review

2021 ◽  
Vol 10 (7) ◽  
pp. 1413
Author(s):  
Judith Catella ◽  
Anne Long ◽  
Lucia Mazzolai
Keyword(s):  
Arterial Disease ◽  
Major Amputation ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Quality Of Data ◽  
Amputation Level ◽  
Increased Risk ◽  
Transcutaneous Oximetry ◽  
Peripheral Arterial

Some patients still require major amputation for lower extremity peripheral arterial disease treatment. The purpose of pre-operative amputation level selection is to determine the most distal amputation site with the highest healing probability without re-amputation. Transcutaneous oximetry (TcPO2) can detect viable tissue with the highest probability of healing. Several factors affect the accuracy of TcPO2; nevertheless, surgeons rely on TcPO2 values to determine the optimal amputation level. Background about the development of TcPO2, methods of measurement, consequences of lower limb amputation level, and the place of TcPO2 in the choice of the amputation level are reviewed herein. Most of the retrospective studies indicated that calf TcPO2 values greater than 40 mmHg were associated with a high percentage of successful wound healing after below-knee-amputation, whereas values lower than 20 mmHg indicated an increased risk of unsuccessful healing. However, a consensus on the precise cut-off value of TcPO2 necessary to assure healing is missing. Ways of improvement for TcPO2 performance applied to the optimization of the amputation-level are reported herein. Further prospective data are needed to better approach a TcPO2 value that will promise an acceptable risk of re-amputation. Standardized TcPO2 measurement is crucial to ensure quality of data.

Complex antithrombotic therapy and bleeding risk in patients with peripheral arterial disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Tseng ◽  
S Bhatt ◽  
M Girardo ◽  
D Liedl ◽  
P Wennberg ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Triple Therapy ◽  
Major Bleeding ◽  
Antithrombotic Therapy ◽  
Oral Anticoagulants ◽  
Bleeding Risk ◽  
Arterial Disease ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Peripheral Arterial

Abstract Introduction Antiplatelet therapy is the cornerstone of treatment for many atherosclerotic vascular pathologies including peripheral arterial disease (PAD). Patients with PAD often have comorbid conditions that require complex antithrombotic therapy, i.e. combined antiplatelet and anticoagulation. Methods All adult patients undergoing ankle brachial index (ABI) measurements were included in the study. ABI values between 1.00 and 1.40 were considered normal, and values below 1.00 or above 1.40 were considered PAD. Demographic, comorbidity and outcome data were obtained using diagnostic codes from the electronic health record. Three medication classes were analyzed: aspirin, non-aspirin oral antiplatelets (e.g. P2Y12 inhibitors) and oral anticoagulants (warfarin and the direct oral anticoagulants). Medication use was determined for patients who had been on a medication for at least one year. Cox proportional hazard analysis for the time to first bleeding event was analyzed. Bleeding was defined as any bleeding requiring medical evaluation (including clinically-relevant non-major bleeding and major bleeding). Results In all, 40,144 patients were included in the analysis (mean age 66±15, 43% female). Patients with PAD were more likely to be on double therapy (one antiplatelet with anticoagulation) (28% vs 19%) and triple therapy (dual antiplatelet with anticoagulation) (10% vs 4%). Unadjusted hazard ratios for bleeding risk showed increased risk of bleeding for patients with PAD (1.18, 95% confidence interval [CI]: 1.08–1.29), though the association is no longer present after adjustment for antithrombotic therapy. Adjusting for age, sex and PAD class, compared to no antithrombotic therapy, there was increased risk of bleeding for monotherapy (1.91, 95% CI: 1.61–2.26), double therapy (3.40, 95% CI: 2.89–4.00) and triple therapy (5.00, 95% CI: 4.21–5.96). Among medications, aspirin and anticoagulant use was independently associated with the greatest increase in risk of bleeding. Conclusion Patients in PAD are at increased risk of bleeding secondary to antithrombotic therapy. Complex antithrombotic therapy with double or triple therapy confer additional bleeding risk, particularly regimens containing aspirin and oral anticoagulants. Funding Acknowledgement Type of funding source: None

scholarly journals Extremely elevated lipoprotein (a) as an independent risk factor for peripheral arterial disease in large patient cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.R Poudel ◽  
S Kirana ◽  
D Stoyanova ◽  
K.P Mellwig ◽  
D Hinse ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Arterial Disease ◽  
P Value ◽  
Lipoprotein A ◽  
Large Patient ◽  
Increased Risk ◽  
Revascularization Therapy ◽  
Peripheral Arterial

Abstract Background Elevated lipoprotein (a) [LP (a)] levels are an independent, genetic, and causal factor for cardiovascular disease and associated with myocardial infarction (MI). Although the association between circulating levels of lipoprotein(a) [Lp(a)] and risk of coronary artery disease (CAD) is well established, its role in risk of peripheral arterial disease (PAD) remains unclear. PAD affects over 236 million individuals and follows ischaemic heart disease (IHD) and cerebrovascular disease (CVD) as the third leading cause of atherosclerotic cardiovascular morbidity worldwide. LP (a) is genetically determined, stable throughout life and yet refractory to drug therapy. While 30 mg/dl is considered the upper normal value for LP (a) in central Europe, extremely high LP (a) levels (>150mg/dl) are rare in the general population. The aim of our study was to analyse the correlation between lipoprotein (a) [LP (a)] levels and an incidence of PAD in high-risk patients. Patients and methods We reviewed the LP (a) concentrations of 52.898 consecutive patients admitted to our cardiovascular center between January 2004 and December 2014. Of these, 579 patients had LP (a) levels above 150 mg/dl (mean 181.45±33.1mg/dl). In the control collective LP (a) was <30mg/dl (n=350). Other atherogenic risk factors in this group were HbA1c 6.58±1.65%, low density lipoprotein (LDL) 141.99±43.76 mg/dl, and body mass index 27.81±5.61. 54.40% were male, 26.07% were smokers, 93.2% had hypertension, and 24% had a family history of cardiovascular diseases. More than 82.6% were under statins. The mean glomerular filtration rate (GFR) was 69.13±24.8 ml/min [MDRD (Modification of Diet in Renal Disease)]. Results 45.00% (n=261) of the patients with LP (a) >150mg/dl had PAD. The prevalence of PAD in patients with LP (a) <30mg/dl in our control collective was 15.8%. (P- Value 0.001). Patients with LP (a) >150mg/dl had a significantly increased risk for PAD (Odds ratio 4.36, 95% CI 2.94–6.72, p: 0.001). 19.1% of patients were re-vascularized by percutaneous angioplasty (PTA) and 7.09% of patients had to undergo peripheral vascular bypass (PVB). Mean LP (a) level in patients with PAD was 182.6±31.61. Conclusion Elevated LP (a) levels above 150 mg/dl are associated with a significantly increased risk of PAD in our collective and it confirms our hypothesis. Over one fourth of these patients had severe PAD and requiring revascularization therapy. We need more prospective studies to confirm our findings. Funding Acknowledgement Type of funding source: None

scholarly journals Increased risk of peripheral arterial disease in polymyalgia rheumatica: a population-based cohort study

2009 ◽  
Vol 11 (2) ◽  
pp. R50 ◽  
Author(s):  
Kenneth J Warrington ◽  
Elena P Jarpa ◽  
Cynthia S Crowson ◽  
Leslie T Cooper ◽  
Gene G Hunder ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Polymyalgia Rheumatica ◽  
Arterial Disease ◽  
Population Based ◽  
Increased Risk ◽  
Peripheral Arterial

Lipoprotein(a) as a unique primary risk factor for early atherosclerotic peripheral arterial disease

2021 ◽  
Vol 14 (6) ◽  
pp. e243231
Author(s):  
John Mayo ◽  
Thomas Hoffman ◽  
Ryan Smith ◽  
Dwight Kellicut
Keyword(s):  
Risk Factor ◽  
Cardiovascular Diseases ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Common Condition ◽  
Elevated Plasma ◽  
Early Screening ◽  
Lipoprotein A ◽  
Peripheral Arterial ◽  
Primary Risk Factor

Elevated plasma lipoprotein(a) is a relatively common condition that contributes to many cardiovascular diseases. However, the awareness and testing for this condition remain low. Herein, we present a case of an otherwise healthy and active man who developed symptoms of peripheral arterial disease starting at age 49, and was found to have hyper-lipoprotein(a) as his only notable risk factor. Diagnosis was not made until years later, after an extensive workup. Upon further screening, he was also found to have subclinical coronary and carotid artery atherosclerotic disease. The patient was treated with aspirin, statin, niacin and angioplasty to bilateral superficial femoral arteries with good symptom resolution. Early screening of his son also revealed a similarly elevated lipoprotein(a) level. It is important to raise awareness of this condition and its relationship to early-onset peripheral arterial disease so patients and their families can be appropriately identified, counselled and treated.

Abstract P081: Markers of Endothelial Function and Peripheral Arterial Disease among Women

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sona Rivas-Tumanyan ◽  
Kenneth J Mukamal ◽  
Jennifer K Pai ◽  
Kaumudi J Joshipura
Keyword(s):  
Myocardial Infarction ◽  
Peripheral Arterial Disease ◽  
Endothelial Function ◽  
Conditional Logistic Regression ◽  
Relative Weight ◽  
Serum Levels ◽  
Arterial Disease ◽  
Blood Draw ◽  
Increased Risk ◽  
Peripheral Arterial

Introduction: Markers of endothelial function may be associated with increased risk for cardiovascular disease; however, prospective data for peripheral arterial disease (PAD) are limited. We evaluated the hypothesis that serum markers of endothelial dysfunction are associated with an increased risk of PAD among women. Methods: We conducted a nested case-control study within an ongoing prospective cohort of U.S. female nurses (Nurses’ Health Study). Among 32,826 NHS participants who provided blood samples in 1989-1990, after excluding those who had myocardial infarction, coronary heart disease, stroke, or carotid artery surgery prior to the PAD diagnosis, we included all incident PAD cases that occurred between 1990 and 2008 and were confirmed by medical records. Each case was individually matched with three eligible controls using risk-set sampling, by age, smoking, date of blood draw, and fasting status. We evaluated the association between serum levels of soluble intercellular adhesion molecule (ICAM-1), E-selectin, and the risk of PAD, using conditional logistic regression analysis. Results: Complete biomarker data from 1990 was available for 144 cases and 431 controls. After accounting for matching factors, baseline ICAM-1 levels were associated with higher risk of PAD (RR for highest (T3) vs. lowest (T1) tertile=1.75, 95% CI: 1.05-2.90). The association was attenuated and no longer significant (RR T3 vs. T1=1.37, 95% CI: 0.75-2.49) after adjusting for serum levels of HDL and LDL-cholesterol, family history of myocardial infarction, relative weight, reported aspirin and cholesterol-lowering medication use, hypertension and diabetes diagnoses, physical activity, and pack-years of smoking. Additional adjustment for CRP levels further attenuated the relative risk (RR T3 vs. T1= 1.24, 95% CI: 0.67-2.29). We did not observe any significant association between baseline E-selectin levels and the risk of PAD (multivariate- and CRP-adjusted RR T3 vs. T1=0.93, 95% CI: 0.54-1.59). Conclusions: There was no association between ICAM-1 and E-selectin and subsequent PAD in this cohort of U.S women.

scholarly journals Increased Risk of Peripheral Arterial Disease After Hip Replacement

Medicine ◽  
2015 ◽  
Vol 94 (19) ◽  
pp. e870 ◽  
Author(s):  
Tzu-Yi Chou ◽  
Ta-Wei Su ◽  
Herng-Jeng Jou ◽  
Pei-Yu Yang ◽  
Hsuan-Ju Chen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Hip Replacement ◽  
Arterial Disease ◽  
Increased Risk ◽  
Peripheral Arterial

scholarly journals The Association Between Pleural Empyema and Peripheral Arterial Disease in Younger Patients: A Retrospective National Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Tzu-Yuan Wang ◽  
Hsin-Hung Chen ◽  
Chun-Hung Su ◽  
Sheng-Pang Hsu ◽  
Chun-Wei Ho ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Pleural Empyema ◽  
Arterial Disease ◽  
Population Based ◽  
Rank Test ◽  
Research Database ◽  
Increased Risk ◽  
Using Data ◽  
Peripheral Arterial

Background: To investigate the relationship between pleural empyema (PE) and peripheral arterial disease (PAD).Methods: We conducted a retrospective cohort study using data from the National Health Institute Research Database. Univariable and multivariable Cox's proportional hazard regressions were performed to investigate the association between PE and the risk of PAD. Kaplan–Meier method and the differences were assessed using a log-rank test.Results: The overall incidence of PAD was higher in the PE cohort than in the non-PE cohort (2.76 vs. 1.72 per 1,000 person-years) with a crude hazard ratio (HR) of 1.61 [95% confidence interval (CI) = 1.41–1.83]. After adjustment for age, gender, and comorbidities, patients with PE were noted to be associated with an increased risk of PAD compared with those without PE [adjusted HR (aHR) = 1.18, 95% CI = 1.03–1.35]. Regarding the age-specific comparison between the PE and non-PE cohorts, PAD was noted to be significantly high in the ≤ 49 years age group (aHR = 5.34, 95% CI = 2.34–10.1). The incidence of PAD was higher in the first 2 years, with an aHR of 1.35 (95% CI = 1.09–1.68) for patients with PE compared with those without PE.Conclusion: The risk of PAD was higher if patients with PE were younger than 49 years and within the 2-year diagnosis of PE.

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