Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis

Fowkes, F. G. R.; Rudan, Diana; Rudan, Igor; Aboyans, Victor; Denenberg, Julie O.; McDermott, Mary M.; Norman, Paul; Sampson, Uchechukwe K A; Williams, Linda; Mensah, George A.; Criqui, Michael H.

doi:10.1016/s0140-6736(13)61249-0

Cited by 2,917 publications

(2,206 citation statements)

References 55 publications

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“…(23) Smoking is a potent risk factor for lower limb atherosclerosis. (5,20,24,25) Interestingly, in this series smoking lowered the risk to undergo intervention with critical limb ischaemia. The reason for this relationship is not fully understood.…”

Section: Discussionmentioning

confidence: 64%

“…In the case of multiple interventions at the same time, only the intervention for the highest severity was retained (excluding 2744 interventions). Furthermore, only interventions addressing Fontaine severity stages IIa, IIb, III and IV (corresponding to Rutherford categories [1][2][3][4][5][6] were retained (excluding a further 39 patients). This resulted in a final sample size of 3406 patients.…”

Section: Resultsmentioning

confidence: 99%

“…(1)(2)(3)(4)(5) Its prevalence is associated with the number of risk factors. (6) It has also been shown that risk factor control is worse in patients with PAD compared to coronary artery disease and cerebrovascular disease.…”

Section: Introductionmentioning

confidence: 99%

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Impact of cardiovascular risk factors on severity of peripheral artery disease

et al. 2015

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Section: Discussionmentioning

confidence: 64%

Section: Resultsmentioning

confidence: 99%

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Impact of cardiovascular risk factors on severity of peripheral artery disease

et al. 2015

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“…There are a number of proven therapies to reduce mortality among patients with PAD including antiplatelet agents, lipid‐lowering therapy with the statins, and aggressive cardiovascular risk factor modification 6. Unfortunately, lifesaving medications are underprescribed among patients with PAD, particularly in comparison with patients with CAD,23 and also the true atherosclerosis burden and mortality risk of PAD are underestimated 9, 10. In contrast, the overall rate of use of cardioprotective medication for secondary prevention in our study cohort was relatively high; at baseline 70% were on statins, 76% on aspirin, 69% on β‐blockers, and 60% on angiogensin‐converting enzyme inhibitor/angiotensin‐receptor blockers.…”

Section: Discussionmentioning

confidence: 99%

Trimethylamine N ‐Oxide and Mortality Risk in Patients With Peripheral Artery Disease

Senthong

Wang

Fan

et al. 2016

JAHA

144

110

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BackgroundProduction of the proatherogenic metabolite, trimethylamine N‐oxide (TMAO), from dietary nutrients by intestinal microbiota enhances atherosclerosis development in animal models and is associated with atherosclerotic coronary artery disease in humans. The utility of studying plasma levels of TMAO to risk stratify in patients with peripheral artery disease (PAD) has not been reported.Methods and ResultsWe examined the relationship between fasting plasma TMAO and all‐cause mortality (5‐year), stratified by subtypes of PAD and presence of coronary artery disease in 935 patients with PAD who underwent elective angiography for cardiac evaluation at a tertiary care hospital. Median plasma TMAO was 4.8 μmol/L (interquartile range, 2.9–8.0 μmol/L). Elevated TMAO levels were associated with 2.7‐fold increased mortality risk (fourth versus first quartiles, hazard ratio 2.86, 95% CI 1.82–3.97, P<0.001). Following adjustments for traditional risk factors, inflammatory biomarkers, and history of coronary artery disease, the highest TMAO quartile remained predictive of 5‐year mortality (adjusted hazard ratio 2.06, 95% CI 1.36–3.11, P<0.001). Similar prognostic value for elevated TMAO was seen for subjects with carotid artery, non–carotid artery, or lower extremity PAD. TMAO provided incremental prognostic value for all‐cause mortality (net reclassification index, 40.22%; P<0.001) and improvement in area under receiver operator characteristic curve (65.7% versus 69.4%; P=0.013).Conclusions TMAO, a pro‐atherogenic metabolite formed by gut microbes, predicts long‐term adverse event risk and incremental prognostic value in patients with PAD. These findings point to the potential for TMAO to help improve selection of high‐risk PAD patients with or without significant coronary artery disease, who likely need more aggressive and specific dietary and pharmacologic therapy.

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“…Peripheral artery disease (PAD) is a global pandemic affecting 8 million to 10 million adults in the United States and >200 million people worldwide 1. Black patients have a 2‐ to 3‐fold higher prevalence of PAD than white patients 2.…”

mentioning

confidence: 99%

Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease

Arya

Binney

Khakharia

et al. 2018

JAHA

171

117

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BackgroundBlack race has been shown to be a risk factor for amputation in peripheral artery disease (PAD); however, race has been argued to be a marker for socioeconomic status (SES) rather than true disparity. The aim of this study is to study the impact of race and SES on amputation risk in PAD patients.Methods and ResultsPatients with incident PAD in the national Veterans Affairs Corporate Data Warehouse were identified from 2003 to 2014 (N=155 647). The exposures were race and SES (measured by median income in residential ZIP codes). The outcome was incident major amputation. Black veterans were significantly more likely to live in low‐SES neighborhoods and to present with advanced PAD. Black patients had a higher amputation risk in each SES stratum compared with white patients. In Cox models (adjusting for covariates), black race was associated with a 37% higher amputation risk compared with white race (hazard ratio: 1.37; 95% confidence interval, 1.30–1.45), whereas low SES was independently predictive of increased risk of amputation (hazard ratio: 1.12; 95% confidence interval, 1.06–1.17) and showed no evidence of interaction with race. In predicted amputation risk analysis, black race and low SES continued to be significant risk factors for amputation regardless of PAD presentation.ConclusionsBlack race significantly increases the risk of amputation within the same SES stratum compared with white race and has an independent effect on limb loss after controlling for comorbidities, severity of PAD at presentation, and use of medications.

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Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis

Cited by 2,917 publications

References 55 publications

Impact of cardiovascular risk factors on severity of peripheral artery disease

Impact of cardiovascular risk factors on severity of peripheral artery disease

Trimethylamine N ‐Oxide and Mortality Risk in Patients With Peripheral Artery Disease

Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease

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