Contemporary cardiovascular risk and secondary preventive drug treatment patterns in peripheral artery disease patients undergoing revascularization

Sigvant, Birgitta; Kragsterman, Björn; Falkenberg, Mårten; Hasvold, Pål; Johansson, Saga; Thuresson, Marcus; Nordanstig, Joakim

doi:10.1016/j.jvs.2016.03.429

Cited by 93 publications

(74 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5 A slightly higher adherence rate was demonstrated for patients undergoing lower limb revascularization in Sweden 1 year postoperatively, with use of acetylsalicylic acid, ACE inhibitors, and statins of 75%, 40%, and 50%, respectively. 8 In addition to reducing CV risk, treatment aims for PAD include the management of limb symptoms. PAD is associated with functional limitations or rest pain and skin ulcers, which can lead to gangrene.…”

Section: Discussionmentioning

confidence: 99%

“…7 In reality, systemic vascular events may not be optimally treated in patients with PAD. 8,9 Current recommendations for PAD include regular antiplatelet therapy and as-needed treatment with statins and antihypertensive drugs to achieve target values for serum lipids and blood pressure, respectively. 7,10,11 Knowledge of drug therapy use in large, unselected PAD populations is scarce and the impact of atherosclerotic manifestations is not well understood.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular outcomes in patients with peripheral arterial disease as an initial or subsequent manifestation of atherosclerotic disease: Results from a Swedish nationwide study

Sigvant

Hasvold

Kragsterman

et al. 2017

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Cardiovascular outcomes in patients with peripheral arterial disease as an initial or subsequent manifestation of atherosclerotic disease: Results from a Swedish nationwide study

Sigvant

Hasvold

Kragsterman

et al. 2017

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Lower-extremity amputation and ulceration were associated with increased risk of major macrovascular events, and of cardiovascular and non-cardiovascular death in patients with diabetes [26–29]. The risk of major cardiovascular events was also high in patients with PAD undergoing peripheral revascularization in a general population cohort including 39 % of participants with diabetes [30]. The pathophysiological links by which PAD might predispose to poor vascular outcomes have not yet been fully elucidated in patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study

Mohammedi

Woodward

Hirakawa

et al. 2016

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background: Peripheral arterial disease (PAD) is known to be associated with high cardiovascular risk, but the individual impact of PAD presentations on risk of macrovascular and microvascular events has not been reliably compared in patients with type 2 diabetes. We aimed to evaluate the impact of major PAD, and its different presentations, on the 10-year risk of death, major macrovascular events, and major clinical microvascular events in these patients. Methods:Participants in the action in diabetes and vascular disease: PreterAx and DiamicroN modified-release controlled evaluation (ADVANCE) trial and the ADVANCE-ON post-trial study were followed for a median of 5.0 (in-trial), 5.4 (post-trial), and 9.9 (overall) years. Major PAD at baseline was subdivided into lower-extremity chronic ulceration or amputation secondary to vascular disease and history of peripheral revascularization by angioplasty or surgery.Results: Among 11,140 participants, 516 (4.6 %) had major PAD at baseline: 300 (2.7 %) had lower-extremity ulceration or amputation alone, 190 (1.7 %) had peripheral revascularization alone, and 26 (0.2 %) had both presentations. All-cause mortality, major macrovascular events, and major clinical microvascular events occurred in 2265 (20.3 %), 2166 (19.4 %), and 807 (7.2 %) participants, respectively. Compared to those without PAD, patients with major PAD had increased rates of all-cause mortality (HR 1.35, 95 % CI 1.15-1.60, p = 0.0004), and major macrovascular events (1.47 [1.23-1.75], p < 0.0001), after multiple adjustments for region of origin, cardiovascular risk factors and treatments, peripheral neuropathy markers, and randomized treatments. We have also observed a trend toward an association of baseline PAD with risk of major clinical microvascular events [1.31 (0.96-1.78), p = 0.09]. These associations were comparable for patients with a lower-extremity ulceration or amputation and for those with a history of peripheral revascularization. Furthermore, the risk of retinal photocoagulation or blindness, but not renal events, increased in patients with lower-extremity ulceration or amputation [1.53 (1.01-2.30), p = 0.04].Conclusions: Lower-extremity ulceration or amputation, and peripheral revascularization both increased the risks of death and cardiovascular events, but only lower-extremity ulceration or amputation increased the risk of severe retinopathy in patients with type 2 diabetes. Screening for major PAD and its management remain crucial for cardiovascular prevention in patients with type 2 diabetes (ClinicalTrials.gov number, NCT00949286).

show abstract

“…Однако в реаль-ной клинической практике до сих пор у больных ОЗАНК данная медикаментозная терапия используется недостаточно [9]. Например, сочетанное применение статинов и антиагрегантов по данным национального регистра в Швеции было использовано у 65% боль-ных с симптомами перемежающейся хромоты и у 45% больных с критической ишемией конечности, и существенно не изменилось в последние 5 лет [23].…”

Section: Factors Of Mortality In Atherosclerosis Of Lower Limbs Arterunclassified

Factors Influencing on the Mortality in Patients With Obliterating Diseases of Lower Limb Arteries

Sumin

Косова

Medvedeva

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

View full text Add to dashboard Cite

1 Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний Россия, 650000, Кемерово, Сосновый б-р, 6 2 Кемеровский кардиологический диспансер Россия, 650000, Кемерово, Сосновый б-р, 6Цель. Изучить факторы риска, ассоциированные с летальным исходом у пациентов, страдающих облитерирующими заболеваниями артерий нижних конечностей, на этапе амбулаторного наблюдения. Aim. To study the risk factors associated with the fatal outcome in patients with obliterating diseases of the lower extremities arteries at the stage of outpatient observation. Material and methods. The study included 467 patients (381 men and 86 women, the median age -63 years [59;70]) with obliterating atherosclerosis of lower limb arteries >50%. Patients were examined in the framework of the current registry on the basis of the Kemerovo Cardiology Center for the period from 2009 to 2013. The examination included the dynamic observation of an angiosurgeon and a cardiologist, the determination of instrumental and laboratory indicators. During 3 years of follow-up, 42 deaths were registered (8.99% of the total number of patients), including 28 (65%) ones due to cardiovascular diseases. Patients were divided into two groups -with a fatal outcome (9%) and without it (91%).Results. The lethal outcome was associated with the male gender (83%), disability (69.8%), retirement status (85.5%), higher incidence of previously diagnosed myocardial infarction (38.5%), angina pectoris (66.6%), stroke or transient ischemic attack (19%). Lesions of two (86%) and three arterial basins (36%) and significant coronary bed lesions (74%) were more frequent in patients with lethal outcome, they were characterized by a longer smoking experience (17.9 years) and hypertension (14.5 years). Surviving patients were more likely to undergo reconstructive surgeries on lower limb arteries (26.5%). Conclusion. Factors associated with death in patients with obliterating diseases of the lower extremities arteries were angina pectoris [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.04-1.43; p=0.041), smoking experience (OR 1.28, 95% CI 1,24; p=0,023), the duration of hypercholesterolemia (OR 2.01, 95% CI 0.35-4.12; p=0.012) and intermittent claudication (OR 2.01, 95% CI 0.35-4.12; p=0.041), presence of coronary ar-

show abstract

Contemporary cardiovascular risk and secondary preventive drug treatment patterns in peripheral artery disease patients undergoing revascularization

Cited by 93 publications

References 41 publications

Cardiovascular outcomes in patients with peripheral arterial disease as an initial or subsequent manifestation of atherosclerotic disease: Results from a Swedish nationwide study

Cardiovascular outcomes in patients with peripheral arterial disease as an initial or subsequent manifestation of atherosclerotic disease: Results from a Swedish nationwide study

Presentations of major peripheral arterial disease and risk of major outcomes in patients with type 2 diabetes: results from the ADVANCE-ON study

Factors Influencing on the Mortality in Patients With Obliterating Diseases of Lower Limb Arteries

Contact Info

Product

Resources

About