scholarly journals Peripheral Artery Disease and Abdominal Aortic Aneurysm: The Forgotten Diseases in COVID-19 Pandemic. Results from an Observational Study on Real-World Management

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 672
Author(s):  
Francesco Natale ◽  
Raffaele Capasso ◽  
Alfonso Casalino ◽  
Clotilde Crescenzi ◽  
Paolo Sangiuolo ◽  
...  

Background and Objectives: It is well established that patients with peripheral artery disease (PAD) as well abdominal aortic aneurysm (AAA) have an increased cardiovascular (CV) mortality. Despite this higher risk, PAD and AAA patients are often suboptimality treated. This study assessed the CV profile of PAD and AAA patients, quantifying the survival benefits of target-based risk-factors modification even in light of the COVID-19 pandemic. Materials and Methods: PAD and AAA patients admitted for any reason to the Vascular Unit from January 2019 to February 2020 were retrospectively analyzed. Biochemical and CV profiles as well as ongoing medical therapies were recorded. Benefits of CV risk-factors control were estimated using the SMART-REACH model. A follow-up visit during the year 2020 was scheduled. Results: A total of 669 patients were included. Of these, 190 showed AAA and 479 PAD at any stage. Only 54% of PAD and 41% of AAA patients were on lipid-lowering drugs with non-optimal low-density lipoprotein (LDL) levels for most of them. A better control of all modifiable CV risk-factors based on the current guidelines would offer an absolute risk reduction of the mean 10-year CV risk by 9% in PAD and 14% in AAA. Unfortunately, the follow-up visit was lost because of COVID-19 limitations. Conclusions: Lipid profiles of PAD and AAA patients were far from guideline-based targets, and medical management was suboptimal. In our center, the COVID-19 pandemic impacted on the strict surveillance required in these very high-risk patients. The achievement of guideline-based therapeutic targets would definitively confer additional significant benefits in reducing the CV risk in these patients.

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Hisato Takagi ◽  
Takuya Umemoto

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.


2014 ◽  
Vol 7 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Joseph V. Moxon ◽  
Dawei Liu ◽  
Gerard Wong ◽  
Jacquelyn M. Weir ◽  
Ratnesh Behl-Gilhotra ◽  
...  

Vascular ◽  
2020 ◽  
pp. 170853812093712
Author(s):  
Kamil Polok ◽  
Jacek Górka ◽  
Jakub Fronczek ◽  
Teresa Iwaniec ◽  
Karolina Górka ◽  
...  

Objectives To compare preoperative coagulation and fibrinolysis activity and incidence of perioperative complications between patients undergoing vascular procedures for peripheral artery disease and abdominal aortic aneurysm. Methods This is a substudy of a prospective observational cohort study (VISION; NCT00512109) in which we recruited patients aged ≥45 years, undergoing surgery for peripheral artery disease and abdominal aortic aneurysm. Blood samples were obtained 24 h preoperatively to measure platelet count, concentrations of coagulation coagulation (fibrinogen, factor VIII, von Willebrand factor:Ristocetin cofactor, antithrombin III), fibrinolysis (dimer D, plasmin–antiplasmin complexes, tissue plasminogen activator) markers and level of soluble CD40 ligand. Incidence of myocardial infarction, stroke, and death (composite endpoint) was assessed in 30-day follow-up. Results The study group included 131 patients at the mean age of 68.3 years among whom reason for surgery was peripheral artery disease in 77 patients (58.8%) and abdominal aortic aneurysm in 54 patients (41.2%). Peripheral artery disease group was characterized by higher platelet count (250.5 versus 209.5 (×10 3 /µl), p = 0.001), concentrations of fibrinogen (5.4 versus 4.1 (g/l), p < 0.001), factor VIII (176.9 versus 141.9 (%), p < 0.001), von Willebrand factor:Ristocetin cofactor (188.9 versus 152.3 (%), p = 0.009), and soluble CD40 ligand (9016.0 versus 7936.6 (pg/ml), p = 0.005). The dimer D level was higher (808.0 versus 2590.5 (ng/ml), p < 0.001) in the abdominal aortic aneurysm group. Incidence of major cardiovascular events (death, myocardial infarction, stroke) within 30 days from surgery did not differ between the groups (39.0% versus 29.6%, p = 0.27). Conclusions The study suggests higher activation of coagulation and relatively lower fibrinolytic activity in peripheral artery disease group compared to patients undergoing surgery for abdominal aortic aneurysm without a significant difference in cardiovascular outcomes.


2021 ◽  
Vol 8 (1) ◽  
pp. 19-23
Author(s):  
Rachid Merghit ◽  
◽  
Ikhlas Gueriane ◽  
Mouloud Ait Athmane ◽  
Abdelhak Lakehal ◽  
...  

Introduction. The rates of atherosclerotic disease as well as its multifocal aspects have been increasing significantly. It is important to know these associations to ensure comprehensive management of this category of patients. Aim. To estimate the frequency of the principal peripheral atherosclerotic associations in patients with coronary artery disease referred to cardiology in the University Hospital of Constantine. Methods. Our study is descriptive, cross-sectional, and mono-centric carried out in the unit of cardiovascular investigations of the Regional Military University Hospital of Constantine. The included patients had at least one significant coronary lesion ≥50 in a principal coronary artery. All our patients underwent an ultrasound evaluation (supra-aortic trunk echo-Doppler, Doppler Ultrasound of the aorta and lower limbs). Data were processed using SPSS Statistics V22. Results. The frequency of the association of Peripheral Artery Disease and Coronary Artery Disease was 34.7% representing the most frequent association. A hemodynamic carotid lesion (≥ 50%) and Abdominal Aortic Aneurysm were associated respectively with Coronary Artery Disease in 12% and 4.6% of patients in the current study. The triple association of coronary artery disease, Abdominal Aortic Aneurysm, and hemodynamic carotid disease was observed in 2.67%, whereas the triple association of Peripheral Artery Disease, coronary artery disease, and carotid stenosis≥50% was observed in 6.67%. The frequency of the association of coronary artery disease, Peripheral Artery Disease, and Abdominal Aortic Aneurysm was estimated at 3, 66%. The therapeutic strategy for multi-focal atherosclerotic disease is still discussed, but coronary artery disease dominates the prognosis. Conclusion. Carrying out a comprehensive assessment of patients with coronary artery disease helps significantly in establishing an adapted and pertinent management with an acceptable BenefitCost Ratio. Keywords: coronary artery disease; peripheral atheromatous disease; pan-vascular therapy.


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