Barriers to screening and diagnosis of peripheral artery disease by general practitioners

Haigh, Kate; Bingley, John; Golledge, Jonathan; Walker, Philip J.

doi:10.1177/1358863x13505673

Cited by 35 publications

(29 citation statements)

References 21 publications

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“…21 Furthermore, availability of equipment, time constraints, and lack of training are reported as major barriers to ankle brachial index testing in primary care. 23 24 25 …”

Section: How Is It Diagnosed?mentioning

confidence: 99%

Diabetic foot

Mishra

Chhatbar²,

Aditi

et al. 2017

BMJ

177

142

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“…21 Furthermore, availability of equipment, time constraints, and lack of training are reported as major barriers to ankle brachial index testing in primary care. 23 24 25 …”

Section: How Is It Diagnosed?mentioning

confidence: 99%

Diabetic foot

Mishra

Chhatbar²,

Aditi

et al. 2017

BMJ

177

142

View full text Add to dashboard Cite

“…Each of these approaches has advantages and disadvantages. ABI for example is a simple and cheap investigation to diagnose PAD but not applied frequently in routine practice [63,64]. Patients with IC alone typically have an ABI of 0.5–0.9, while CLI patients usually have an ABI of <0.4 [23].…”

Section: Potential Biomarkers For Padmentioning

confidence: 99%

A Review of the Pathophysiology and Potential Biomarkers for Peripheral Artery Disease

Krishna

Moxon

Golledge

2015

IJMS

Self Cite

147

113

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Peripheral artery disease (PAD) is due to the blockage of the arteries supplying blood to the lower limbs usually secondary to atherosclerosis. The most severe clinical manifestation of PAD is critical limb ischemia (CLI), which is associated with a risk of limb loss and mortality due to cardiovascular events. Currently CLI is mainly treated by surgical or endovascular revascularization, with few other treatments in routine clinical practice. There are a number of problems with current PAD management strategies, such as the difficulty in selecting the appropriate treatments for individual patients. Many patients undergo repeated attempts at revascularization surgery, but ultimately require an amputation. There is great interest in developing new methods to identify patients who are unlikely to benefit from revascularization and to improve management of patients unsuitable for surgery. Circulating biomarkers that predict the progression of PAD and the response to therapies could assist in the management of patients. This review provides an overview of the pathophysiology of PAD and examines the association between circulating biomarkers and PAD presence, severity and prognosis. While some currently identified circulating markers show promise, further larger studies focused on the clinical value of the biomarkers over existing risk predictors are needed.

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“…There are recognised deficiencies in current methods of predicting and limiting complications in PAD patients [2,3]. Globally, an estimated 382 million people have diabetes and this number will rise to 592 million in 2035 [4].…”

Section: Introductionmentioning

confidence: 99%

Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

Golledge

Quigley

Velu

et al. 2014

Cardiovasc Diabetol

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BackgroundPre-diabetes and untreated diabetes are common in patients with peripheral artery disease however their impact on outcome has not been evaluated. We examined the association of impaired fasting glucose, diabetes and their treatment with the presentation, mortality and requirement for intervention in peripheral artery disease patients.MethodsWe prospectively recruited 1637 patients with peripheral artery disease, measured fasting glucose, recorded medications for diabetes and categorised them by diabetes status. Patients were followed for a median of 1.7 years.ResultsAt entry 22.7% patients were receiving treatment for type 2 diabetes by oral hypoglycaemics alone (18.1%) or insulin (4.6%). 9.2% patients had non-medicated diabetes. 28.1% of patients had impaired fasting glucose (5.6-6.9 mM). Patients with non-medicated diabetes had increased mortality and requirement for peripheral artery intervention (hazards ratio 1.62 and 1.31 respectively). Patients with diabetes prescribed insulin had increased mortality (hazard ratio 1.97). Patients with impaired fasting glucose or diabetes prescribed oral hypoglycaemics only had similar outcomes to patients with no diabetes.ConclusionsNon-medicated diabetes is common in peripheral artery disease patients and associated with poor outcomes. Impaired fasting glucose is also common but does not increase intermediate term complications. Peripheral artery disease patients with diabetes requiring insulin are at high risk of intermediate term mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-014-0147-2) contains supplementary material, which is available to authorized users.

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Barriers to screening and diagnosis of peripheral artery disease by general practitioners

Cited by 35 publications

References 21 publications

Diabetic foot

Diabetic foot

A Review of the Pathophysiology and Potential Biomarkers for Peripheral Artery Disease

Association of impaired fasting glucose, diabetes and their management with the presentation and outcome of peripheral artery disease: a cohort study

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