Lower Extremity Peripheral Arterial Disease Is an Independent Predictor of Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus in China

Pang, Xin; Han, Junfeng; Ye, Wan-lan; Sun, Xue; Ding, Yuanyuan; Huang, Wenjuan; Zhao, Yingxin; Lou, Han-Yu; Shan, Peng-Fei; Kang, Ying-Xiu; Song, Xiaoxiao; Zhang, Songzhao; Gu, Wei

doi:10.1155/2017/9620513

Cited by 27 publications

(16 citation statements)

References 30 publications

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“…Saleh et al found independent association of age, hypertension, diabetes mellitus and smoking with PAD [31]. Another study found PAD was independent risk factor for CAD and CVE [13]. In the present study, hypertension, smoking, history of CVE and presentation with ACS independently increased the risk of LEAD.…”

Section: Predictors Of Peripheral Artery Disease In Patients With Cadsupporting

confidence: 58%

“…SYNTAX score (SS) for coronary angiography has become popular as it can guide the appropriate treatment protocol for revascularization and provides prognostic information [11]. Multiple studies have reported association or correlation of CAD and PAD on the basis of ABI and also invasive peripheral angiography [12][13][14][15]. But rigorous searching did not reveal any research studying the association of CAD and LEAD where severity of PAD was assessed by DUS.…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED ARTICLE: Association of severity of coronary artery disease by SYNTAX score (SS) and lower extremity arterial disease by duplex ultrasound (DUS) study—an Indian perspective

2020

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Background Coronary artery disease (CAD) and lower extremity artery disease (LEAD) often coexist. Ankle brachial index (ABI) has been shown to be an independent predictor of CAD. Studies have reported correlation of CAD and LEAD on the basis of ABI and also invasive angiography. But rigorous searching did not reveal any similar research where severity of LEAD was assessed by duplex ultrasound (DUS). In this study, we assessed the association of severity and localisation of LEAD by DUS with SYNTAX score (SS). Results A total of 637 subjects above 45 years of age with coronary angiographic confirmation of CAD were studied in this single centre cross-sectional, descriptive and analytical research. High SS was significantly more common in subjects with LEAD (p = 0.04). In the femoro-popliteal segment, total occlusion of arteries was found in significantly more proportion of subjects with high SS. A progressive increase in mean SS was noted across the grades of arterial disease in the femoro-popliteal segment (p = 0.007). 85.2% of the LEAD was in the femoro-popliteal segment, while below-knee arterial disease was present in 98.5% of subjects with LEAD. Hypertension, smoking, history of CVE and presentation with ACS independently increased the risk of LEAD. Conclusion High prevalence of asymptomatic LEAD and association of high SS with LEAD as a whole as well as femoro-popliteal involvement suggests the need for a point of care DUS study (POCUS) since treatment varies with location and extent of disease which cannot be fathomed by ABI alone. Being the largest study on association of CAD and LEAD from Indian subcontinent till date and also the first study to use non-invasive tool as DUS for LEAD assessment while studying its association with CAD makes this a landmark experience.

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Section: Predictors Of Peripheral Artery Disease In Patients With Cadsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Association of severity of coronary artery disease by SYNTAX score (SS) and lower extremity arterial disease by duplex ultrasound (DUS) study—an Indian perspective

2020

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“…The epidemiologic data on the prevalence and risk factors of cardiovascular disease in the Dominican Republic are very limited and this is in part due to the lack of proper funds and diagnostic tools. Hyperlipidemia, smoking, hypertension, diabetes and peripheral arterial disease (PAD) are the five main risk factors for cardiovascular diseases [2–5].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of peripheral arterial disease among diabetic patients in Santo Domingo, Dominican Republic and associated risk factors

Mejias

Ramphul

2018

Arch Med Sci Atheroscler Dis

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IntroductionPeripheral arterial disease (PAD) is a major risk factor of coronary artery disease and a major complication of atherosclerosis. Peripheral arterial disease can be diagnosed with simple and low cost techniques. There are major risk factors of PAD that have been studied for different countries. However, no such study has been done for the Dominican Republic. We conducted a cross-sectional study to determine the prevalence of PAD and the risk factors among patients with diabetes in Santo Domingo, Dominican Republic.Material and methodsSix hundred randomly chosen patients with previously diagnosed diabetes were enrolled in our study. Their blood pressure and ankle brachial index were calculated and a questionnaire was provided to gather information regarding gender, age, weight, ethnicity, known duration of diabetes along with any history of smoking, hypertension and hyperlipidemia. A physical examination was also done to assess for any active diabetic ulcers, previous foot ulcers and non-traumatic amputation. A microfilament test was conducted to check for peripheral neuropathy.ResultsEighty-four diabetic patients were diagnosed with PAD with a prevalence of 14% in Santo Domingo, Dominican Republic. Statistically significant associations (p < 0.05) was found for female gender, presence of active foot ulcers, history of past foot ulcer, non-traumatic amputation, hypertension, hyperlipidemia and peripheral neuropathy. Glycated hemoglobin (HbA1c), age and smoking were not statistically significant in our study.ConclusionsDiabetic patients who are either female, have active foot ulcers, a history of past foot ulcer, non-traumatic amputation, hypertension, hyperlipidemia or peripheral neuropathy are more at risk of developing PAD.

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“…Two population cohort studies of diabetes with decreased ABI revealed increased risk of ASCVD. 34 35 Therefore, ABI has role in initiation primary prevention of statin therapy in adults 40 to 75 years of age with LDL-C level 70 to 189 mg/dL. In adults 20 to 39 years of age with diabetes mellitus who have ABI <0.9, it may be reasonable to initiate statin therapy (class IIb).…”

Section: Lipid/biomarkersmentioning

confidence: 99%

The Potential Role of Biomarkers Associated with ASCVD Risk: Risk-Enhancing Biomarkers

Choi

2019

J Lipid Atheroscler

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Serum cholesterol is major risk factor and contributor to atherosclerotic cardiovascular disease (ASCVD). Therapeutic cholesterol-lowering drugs, especially statin, revealed that reduction in low-density lipoprotein cholesterol (LDL-C) produces marked reduction of ASCVD events. In the preventive scope, lower LDL-C is generally accepted as better in proven ASCVD patients and high-risk patient groups. However, in patients with low to intermediate risk without ASCVD, risk assessment is clinically guided by traditional major risk factors. In this group, the complement approach to detailed risk assessment about traditional major risk factors is needed. These non-traditional risk factors include ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, lipoprotein(a) (Lp[a]), apolipoprotein B (apoB), or coronary artery calcium (CAC) score. CAC measurements have an additive role in the decision to use statin therapy in non-diabetic patients 40–75 years old with intermediate risk in primary prevention. This review comprises ASCVD lipid/biomarkers other than CAC. The 2013 and 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines suggest these factors as risk-enhancing factors to help health care providers better determine individualized risk and treatment options especially regarding abnormal biomarkers. The recent 2018 Korean guidelines for management of dyslipidemia did not include these biomarkers in clinical decision making. The current review describes the current roles of hsCRP, ABI, LP(a), and apoB in personal modulation and management of health based on the 2018 ACC/AHA guideline on the management of blood cholesterol.

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Lower Extremity Peripheral Arterial Disease Is an Independent Predictor of Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus in China

Cited by 27 publications

References 30 publications

RETRACTED ARTICLE: Association of severity of coronary artery disease by SYNTAX score (SS) and lower extremity arterial disease by duplex ultrasound (DUS) study—an Indian perspective

RETRACTED ARTICLE: Association of severity of coronary artery disease by SYNTAX score (SS) and lower extremity arterial disease by duplex ultrasound (DUS) study—an Indian perspective

Prevalence of peripheral arterial disease among diabetic patients in Santo Domingo, Dominican Republic and associated risk factors

The Potential Role of Biomarkers Associated with ASCVD Risk: Risk-Enhancing Biomarkers

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