Influence of lipoprotein(a) on restenosis after femoropopliteal percutaneous transluminal angioplasty in Type 2 diabetic patients

Maca, T.; Ahmadi, Ramazanali; Derfler, Kurt; Ehringer, H; Gschwandtner, Michael E.; Wh, Hörl; Katzenschlager, Reinhold; Müller‐Knespel, E.; Koppensteiner, Renate; Schneider, Barbara; Stümpflen, Andreas; Ugurluoglu, Ara; Minar, Erich

doi:10.1046/j.1464-5491.2002.00645.x

Cited by 15 publications

(11 citation statements)

References 40 publications

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“…We found significantly lower Lp(a) values in patients with T2DM than in nondiabetic patients. Consistent with this result from our study, decreased Lp(a) levels in patients with T2DM have been reported earlier when populations with a high prevalence of atherosclerotic disease were investigated [29][30][31].…”

Section: Discussionsupporting

confidence: 93%

Lipoprotein(a), type 2 diabetes and vascular risk in coronary patients

Saely

Koch

Schmid

et al. 2006

Eur J Clin Investigation

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Section: Discussionsupporting

confidence: 93%

Lipoprotein(a), type 2 diabetes and vascular risk in coronary patients

Saely

Koch

Schmid

et al. 2006

Eur J Clin Investigation

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“…The results of PCTA with or without stenting are better for proximal lesions, with reported primary patency rates of 90% at 1 year [10] and 85% at 4 years for iliac angioplasty, and 80% at 1 year for femoral angioplasty. Re‐stenosis rates are higher in diabetic compared with non‐diabetic patients after femoropopliteal PCTA [59] and high lipoprotein(a) levels [59] predict restenosis. Antiplatelet agents and cilostazol reduce restenosis rates after PCTA.…”

Section: Treatmentmentioning

confidence: 99%

Peripheral arterial disease in diabetes—a review

2010

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Diabetic patients are at high risk for peripheral arterial disease (PAD) characterized by symptoms of intermittent claudication or critical limb ischaemia. Given the inconsistencies of clinical findings in the diagnosis of PAD in the diabetic patient, measurement of ankle-brachial pressure index (ABI) has emerged as the relatively simple, non-invasive and inexpensive diagnostic tool of choice. An ABI < 0.9 is not only diagnostic of PAD even in the asymptomatic patient, but is also an independent marker of increased morbidity and mortality from cardiovascular diseases. With better understanding of the process of atherosclerosis, avenues for treatment have increased. Modification of lifestyle and effective management of the established risk factors such as smoking, dyslipidaemia, hyperglycaemia and hypertension retard the progression of the disease and reduce cardiovascular events in these patients. Newer risk factors such as insulin resistance, hyperfibrinogenaemia, hyperhomocysteinaemia and low-grade inflammation have been identified, but the advantages of modifying them in patients with PAD are yet to be proven. Therapeutic angiogenesis, on the other hand, represents a promising therapeutic adjunct in the management of PAD in these patients. Outcomes after revascularization procedures, such as percutaneous transluminal angioplasty and surgical bypasses in diabetic patients, are poorer, with increased perioperative morbidity and mortality compared with that in non-diabetic patients. Amputation rates are higher due to the distal nature of the disease. Efforts towards increasing awareness and intensive treatment of the risk factors will help to reduce morbidity and mortality in diabetic patients with PAD.

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“…Recent studies have also shown an independent association between plasma Lp(a) levels and thoracic aortic atherosclerosis (4) and ischaemic stroke (5). Plasma Lp(a) level is often higher in diabetic patients than in control subjects (6), and is independently associated with femoropoliteal percutaneous transluminal angioplasty restenosis (7) and with some typical diabetes complications such as proliferative retinopathy (8). Hyperhomocysteinemia, a consequence of disturbed methionine metabolism, also appears to be an independent risk factor for atherothrombotic events, even in diabetic subjects (9).…”

Section: Introductionmentioning

confidence: 99%