scholarly journals Associations of Symptomatic or Asymptomatic Peripheral Arterial Disease with All-Cause and Cardiovascular Mortality after 3 Years Follow Up: The China Ankle-Brachial Index Cohort Study

2013 ◽  
Vol 02 (03) ◽  
Author(s):  
Xiankai Li Yidong Wei ◽  
DachunXu Yang Han ◽  
Chang Liang Jianying Shen
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Cardiovascular Mortality ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Peripheral Arterial

Abstract 278: Lipid Control in Patients With New Symptoms of Peripheral Arterial Disease Evaluated at Vascular Specialty Clinics

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Kim Smolderen ◽  
Jan-Willem Elshof ◽  
Moniek van Zitteren ◽  
John A Spertus ◽  
Johan Denollet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Secondary Prevention ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Initial Evaluation ◽  
Specialty Clinic ◽  
Lipid Control ◽  
Peripheral Arterial

Background: Obtaining adequate lipid control (LDL-Cholesterol [LDL] <100 mg/dL) in patients with peripheral arterial disease (PAD) is a critical, guideline-directed secondary prevention target. Current compliance with this recommendation is unknown. Methods: A total of 616 patients had their LDL levels measured at 2 vascular specialty clinics in the Netherlands (March 2006-November 2011) during the evaluation of new PAD symptoms. A year following this evaluation, 417 (68%) patients had their LDL levels re-assessed. Information about patients’ demographic and clinical factors was systematically abstracted from medical records. Categories of patients were created based on the attainment of the recommended LDL target (<100 mg/dL [on target] vs. ≥100 mg/dL [off target]). Predictors of being off target at initial evaluation and at 1-year follow-up were identified through multivariable logistic regression analyses. Results: Of the total group, 57% (351/616) were off target at initial evaluation and 81% (496/616) were on lipid-lowering drugs after the initial evaluation at the PAD specialty clinic. One year later, only 25% (103/417) got on target, while 35% (147/417) patients remained off target, and an additional 10% (43/417) saw an increase in LDL to become off target. A total of 30% (124/417) remained on target. Patients with hypertension, diabetes, a history of myocardial infarction, and a lower ankle-brachial index were less likely to be off target at initial evaluation. Predictors of being off target at 1-year follow-up were male sex, and having a higher ankle-brachial index ( Table ). Conclusion: About half of patients with PAD seen at vascular specialty clinics had above-target LDL levels both upon entry and 1 year later. Patients with existing cardiovascular risk factors were much better controlled, as compared with patients without such risk factors. Males and those with higher ankle-brachial indices were less likely to be on target 1 year following management at the specialty clinic. Reasons for poorly regulated lipids need to be further explored, and appropriate quality-of-care improvement strategies will likely be needed to optimize secondary prevention.

scholarly journals Penyakit Arteri Perifer dan Mortalitas Kardiovaskular pada Pasien Diabetes Melitus Tipe-2

2019 ◽  
Vol 6 (2) ◽  
pp. 100
Author(s):  
Em Yunir ◽  
Dekta Filantropi Esa ◽  
Adelia Nova Prahasary ◽  
Dicky Levenus Tahapary
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Cardiovascular Mortality ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Peripheral Arterial ◽  
Diabetes Melitus

Peripheral arterial disease (PAD) merupakan salah satu komplikasi makrovaskular diabetes melitus tipe 2 (DMT2) yang dikaitkan dengan peningkatan risiko mortalitas kardiovaskular. Pemeriksaan ankle-brachial index (ABI) merupakan salah satu pemeriksaan yang sederhana dan mudah dilakukan untuk menegakkan diagnosis PAD. Oleh karena itu, penulis ingin mengetahui tingkat mortalitas kardiovaskular pasien DMT2 dengan PAD. Dari hasil penelusuran literatur, didapatkan tujuh literatur. Studi Bundo dkk melaporkan hasil HR 2,45 (interval kepercayaan [IK] 95%: 0,84-7,17). Studi Mostaza dkk melaporkan hasil HR 1,64 (IK 95%: 0,64-4,49). Studi Aboyans dkk melaporkan hasil HR 2,21 (IK 95%: 1,16-4,22). Studi Mohammedi dkk melaporkan hasil HR 1,35 (IK 95%: 1,15-1,60). Studi Quiles dkk melaporkan hasil HR 6,61 (IK 95%: 2,47-17,72). Studi Mueller dkk melaporkan hasil  RR 3,53 (IK 95%: 1,80-6,91). Studi lanjutan Mueller dkk melaporkan hasil  RR 4,06 (IK 95%: 2,67-6,18). Dari hasil studi tersebut, dapat disimpulkan bahwa pasien DMT2 yang disertai dengan PAD akan meningkatkan mortalitas kardiovaskular, serta nilai ABI dapat digunakan sebagai instrumen stratifikasi independen mortalitas kardiovaskularKata Kunci:Ankle brachial index, diabetes melitus tipe 2, mortalitas kardiovaskular, penyakit arteri perifer Peripheral Arterial disease and Cardiovascular Mortality in Type-2 Diabetes MellitusPeripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which increases the risk of cardiovascular mortality. Ankle-brachial index (ABI) is one of the simple and widely available tool to diagnose PAD. The authors aim to find out the cardiovascular mortality in T2DM patient with PAD. Bundo et al. study found HR 2.45 (95% CI: 0.84 to 7.17). Mostaza et al. study reported HR 1.64 (95% CI: 0.64 to 4.49). Aboyans et al. study declared HR 2.21 (95% CI: 1.16 to 4.22). Mohammedi K et al. claimed HR 1.35 (95% CI: 1.15 to 1.60). Quiles et al. found HR 6.61 (95% CI: 2.47 to 17.72). Mueller et al. study reported  RR 3,53 (95% CI: 1.80 to 6.91). Mueller et al. study reported  RR 4,06 ( 95% CI: 2.67 to 6.18).  In conclusion, the mortality risk in T2DM patients with PAD is higher compared to those without PAD. Moreover, an ankle-brachial index can be used as an independent stratification tool to predict the risk of cardiovascular mortality

scholarly journals Lipoprotein-associated phospholipase A2 and risk of incident peripheral arterial disease in a multi-ethnic cohort: The Multi-Ethnic Study of Atherosclerosis

2016 ◽  
Vol 22 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Parveen K Garg ◽  
Neal W Jorgensen ◽  
Robyn L McClelland ◽  
Nancy S Jenny ◽  
Michael H Criqui ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Significant Interaction ◽  
Regression Models ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Adjusted Logistic Regression ◽  
Peripheral Arterial

Prospective studies supporting a relationship between elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) and incident peripheral arterial disease (PAD) are limited. We evaluated the association of Lp-PLA2 with incident PAD in a multi-ethnic cohort without clinical cardiovascular disease. A total of 4622 participants with measurement of Lp-PLA2 mass and Lp-PLA2 activity and an ankle–brachial index (ABI) between 0.9 and 1.4 were followed for the development of PAD (median follow-up = 9.3 years), defined as an ABI ⩽0.9 and decline from baseline ⩾0.15. There were 158 incident PAD events during follow-up. In adjusted logistic regression models, each higher standard deviation of both Lp-PLA2 activity and mass did not confer an increased risk of developing PAD [odds ratios, (95% confidence intervals)]: 0.92 (0.66–1.27) for Lp-PLA2 activity and 1.06 (0.85–1.34) for mass. Additionally, no significant interaction was found according to ethnicity: p=0.43 for Lp-PLA2 activity and p=0.55 for Lp-PLA2 mass. We found no evidence of an association between Lp-PLA2 and incident PAD.

scholarly journals Vasoactive Biomarkers Associated With Long-Term Incidence of Symptomatic Peripheral Arterial Disease and Mortality

Angiology ◽  
2021 ◽  
pp. 000331972098773
Author(s):  
Ardwan Dakhel ◽  
Gunnar Engström ◽  
Olle Melander ◽  
Stefan Acosta ◽  
Shahab Fatemi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Proportional Hazards ◽  
Arterial Disease ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Peripheral Arterial

We evaluated if plasma biomarkers can predict incident peripheral arterial disease (PAD) and mortality in a longitudinal cohort study. Men (n = 3618) and women (n = 1542) were included in the Malmö Preventive Project and underwent analysis of: C-terminal endothelin-1 (CT-proET-1), N-Terminal prosomatostatin (NT-proSST), midregional proatrial natriuretic peptide (MR-proANP), procalcitonin (PCT), and copeptin. Participants were followed up for incident PAD and mortality until December 31, 2016. Median follow-up was 11.2 years (interquartile range 9.4-12.2). Cumulative incidence of PAD was 4.3% (221/5160), 4.5% in men (164/3618) and 3.7% in women (57/1542; P = .174). In an adjusted Cox proportional hazards regression model, higher CT-proET-1 (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.4-2.3), NT-proSST (HR 1.5; 95% CI 1.2-2.0), and MR-proANP (HR 1.7; 95% CI 1.3-2.3) were independently associated with incident PAD, and higher CT-proET-1 (HR 1.3; 95% CI 1.2-1.5), NT-proSST (HR 1.2; 95% CI 1.1-1.3), MR-proANP (HR 1.4; 95% CI 1.3-1.6), PCT (HR 1.1; 95% CI 1.0-1.2), and copeptin (HR 1.2; 95% CI 1.1-1.4) were independently associated with mortality. Increased levels of CT-proET-1, NT-proSST, and MR-proANP were independently associated with incident PAD, whereas all the vasoactive biomarkers were independently associated with mortality during follow-up.

scholarly journals Drug-coated balloons used in peripheral artery disease: experience from a single center

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094015
Author(s):  
Jinbo Liu ◽  
Tianrun Li ◽  
Wei Huang ◽  
Na Zhao ◽  
Huan Liu ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Single Center ◽  
Single Center Study ◽  
Before And After ◽  
Artery Disease ◽  
Peripheral Arterial

Objective This retrospective single-center study aimed to analyze immediate and follow-up results of using drug-coated balloons (DCBs) for treating peripheral arterial disease. Methods In this study, we identified a total of 75 patients who underwent DCB therapy at our institution. The ankle–brachial index (ABI) was measured before and after intervention. Intermittent claudication and whether there was healing of ulcers were determined by telephone. Results The cohort consisted of 56 men and 19 women aged 38 to 87 years (68 ± 12 years). Twenty-three patients had Rutherford grade III, 15 had Rutherford grade IV, and 37 had Rutherford grade V. Seventeen patients had stents and 18 had the Rotarex system used. The postoperative ABI was significantly greater than the preoperative ABI (0.911 ± 0.173 vs 0.686 ± 0.249). Good results for treatment were obtained. Intermittent claudication and rest pain did not occur in subjects with Rutherford grades III and IV during follow-up. The amputation rate was 4.1% among all patients using DCB therapy during follow-up. Conclusions DCB therapy is safe and effective for treating peripheral arterial disease in real-world patients. Future prospective studies on this issue are recommended.

P1961Clopidogrel compared to aspirin in symptomatic peripheral arterial disease, a nationwide cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Eldrup ◽  
F A T Toegersen ◽  
M S Soegaard ◽  
P B N Nielsen ◽  
T B L Larsen
Keyword(s):  
Myocardial Infarction ◽  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Controlled Trial ◽  
Composite Endpoint ◽  
Arterial Disease ◽  
Eligibility Criteria ◽  
Fatal Stroke ◽  
Peripheral Arterial

Abstract Background Aspirin and clopidogrel is currently recommended as equivalent choices for antithrombotic therapy for peripheral arterial disease (PAD) in both European and US guidelines. A recent meta-analysis quested the efficacy of aspirin in prevention of myocardial infarction and cardiovascular mortality and found it protective only against non-fatal stroke. Clopidogrel, however, was effective against non-fatal myocardial infarction and the composite endpoint of death, non-fatal stroke, and myocardial infarction. Purpose To investigate if clopidogrel provide clinical benefits over aspirin in a national cohort of revascularized patients with PAD. Methods Comparative cohort study including all Danish patients recorded in the Danish Vascular Registry undergoing surgical or endovascular revascularization due to symptomatic PAD in Danish hospital settings from 2000 through 2016. We used multiple national population-based registries to collect individual-level data on comorbidity, medical treatment, and life status. We emulated the principles of a pragmatic randomized controlled trial, i.e. eligibility criteria, exclusion criteria, treatment assignment, and follow-up period, and used inverse probability of treatment weighting to account for treatment confounding. Results 33,381 patients were considered for inclusion, and 15,737 was excluded according to prespecified criteria, leaving 13,653 taking aspirin and 1,312 clopidogrel. There were baseline differences between the two groups, which mitigated after applying treatment weights. Over a mean follow-up of 5.7 years, there were no treatment differences between aspirin (reference) and clopidogrel for outcomes of myocardial infarction, weighted hazard ratio (HR) 0.84 (95% CI; 0.64–1.10); stroke HR 1.09 (0.83–1.41); amputation HR 0.86 (0.66–1.13); and limb revascularisation HR 0.95 (0.73–1.124). For combined cardiovascular endpoints myocardial infarction, stroke or death we found HR 0.89 (0.75–1.05) and combined limb outcome, amputation and revascularisation HR 0.92 (0.75–1.13), Figure 1. Hazard ratios for risk of all bleedings were similar, also when divided on intracranial, gastrointestinal and others. Figure 1 Conclusion In this nationwide cohort of revascularized patients with PAD, clopidogrel in comparison with aspirin showed no difference for cardiovascular outcomes or limb protection. Acknowledgement/Funding None

Increased apoB/apoA-I Ratio is Predictive of Peripheral Arterial Disease in Initially Healthy 58-Year-old Men during 8.9 Years of Follow-up

Angiology ◽  
2008 ◽  
Vol 60 (5) ◽  
pp. 539-545 ◽  
Author(s):  
L. Johansson ◽  
C. Schmidt
Keyword(s):  
Peripheral Arterial Disease ◽  
Femoral Artery ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Increased Risk ◽  
Peripheral Arterial ◽  
Old Men ◽  
The City

The aim of the present study was to investigate, if increased levels of apoB/apoA-I ratios are associated with future peripheral arterial disease as measured by ankle-brachial index. Increased apoB/apoA-I levels are defined as 0.9, which has been suggested for men, and as 0.63, which has observed to be associated with plaques in the femoral artery. The study was performed in a cohort of initially clinically healthy 58-year-old men living in the city of Göteborg, Sweden. The group with an apoB/apoA-I ratio ≥0.9 had a significantly increased risk of having PAD during 8.9 years of follow-up than the group below that level (OR: 2.15 CI: 1.21 to 3.82, p < 0.01). When applying the lower apoB/apoA-I cut off, results showed that the group with a level >0.63 had more than a three-fold risk of future PAD compared to the group ≤0.63 (OR: 3.28 CI: 1.14 to 9.40, p < 0.05).

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