Prevalence and associations of subclinical peripheral artery disease among patients with type 2 diabetes without clinical macrovascular disease

Weerarathna, Thilak Priyantha; Herath, Meththananda; Liyanage, Gayani; Weerarathna, Miyuru Kavinda; Senadheera, Vidarsha

doi:10.4103/ijpvm.ijpvm_427_18

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…This holds true particularly also for a majority of patients with T2DM, among whom PAD is one of the most common manifestations of macrovascular disease. [24][25][26][27] Already non-diabetic CAD patients (and, even, most T2DM patients without CAD) are considered to be at a very high risk of cardiovascular events according to current ESC guidelines and should meet an LDL cholesterol treatment goal of at least <55 mg/dL. 28 Our data demonstrate the important prognostic differences between different patient populations subsumed in the current ESC category of very high risk.…”

Section: Discussionmentioning

confidence: 71%

Type 2 diabetes and the risk of cardiovascular events in peripheral artery disease versus coronary artery disease

Sprenger

Mader

Larcher

et al. 2021

BMJ Open Diab Res Care

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IntroductionThe prevalence of type 2 diabetes mellitus (T2DM) is higher in peripheral artery disease (PAD) than in coronary artery disease (CAD) patients, and PAD overall confers higher cardiovascular risk than CAD. How cardiovascular risk compares between PAD and CAD patients when analyses are stratified by the presence of type 2 diabetes is unclear and is addressed in the present study.Research design and methodsWe prospectively recorded major cardiovascular events (MACE; ie, cardiovascular death, myocardial infarction or stroke) over 10.0±4.7 years in 923 patients with stable CAD, of whom 26.7% had T2DM and in 292 patients with PAD, of whom 42.1% had T2DM. Four groups were analyzed: CAD patients without diabetes (CAD/T2DM−; n=677), CAD patients with T2DM (CAD/T2DM+; n=246), PAD patients without diabetes (PAD/T2DM−; n=169) and PAD patients with T2DM (PAD/T2DM+; n=123).ResultsThe event rate for MACE increased over our four investigated groups: it was lowest in CAD/T2DM− patients (2.52 events per 100 person-years). It was significantly higher in CAD/T2DM+ patients (3.96 events per 100 person-years; p<0.001), in PAD/T2DM− patients (3.68 events per 100 person-years; p=0.022), and in PAD/T2DM+ patients (7.10 events per 100 person-years; p<0.001), who in turn were at a higher risk than CAD/T2DM+ or PAD/T2DM− patients (p=0.001 and p<0.001, respectively). Cox regression analysis after multivariate adjustment showed that the presence of T2DM (HR=1.44 (95% CI 1.09 to 1.92); p=0.012) and the presence of PAD versus CAD (HR=1.48 (95% CI 1.15 to 1.91); p=0.002) were mutually independent predictors of cardiovascular events.ConclusionsIn conclusion, our data show that T2DM as well as the presence of PAD versus CAD are mutually independent predictors of MACE. Patients with both PAD and T2DM are at an exceedingly high risk of cardiovascular events.

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Section: Discussionmentioning

confidence: 71%

Type 2 diabetes and the risk of cardiovascular events in peripheral artery disease versus coronary artery disease

Sprenger

Mader

Larcher

et al. 2021

BMJ Open Diab Res Care

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“…In the MER-ITO study, the prevalence of smoking in patients with CKD was 11.1% (Mostaza et al, 2006). In a study by Herath et al (2019) there was no difference in pack-years of smoking between subjects with GFR above or below 60ml/min/1.73m (Herath et al, 2019).…”

Section: Resultsmentioning

confidence: 92%

“…Graph 3 shows the prevalence of peripheral vascular disease as determined by ABI<0.9 was 31.1%. Studies by Guerrero et al (2006);de Vinuesa et al (2005) and Herath et al (2019) in which the prevalence of PAD was 24%, 19%, 32% and 29% respectively (Guerrero et al, 2006;de Vinuesa et al, 2005;Herath et al, 2019).…”

Section: Resultsmentioning

confidence: 97%

A Study on Carotid Intima-Media Thickness and Ankle Brachial Index In Patients with Various Stages of Chronic Kidney Disease

Dhileepan

Mariraj

et al. 2020

ijrps

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The presence of peripheral vascular disease in chronic kidney disease portends a dismal prognosis due to the increased morbidity and mortality from cardiovascular events. Peripheral vascular disease is asymptomatic in about 40%. The study was designed to identify the prevalence of the peripheral vascular disease in chronic kidney disease, which is a state of accelerated atherosclerosis. A sample of 90 patients of chronic kidney disease attending the outpatient department in medicine and nephrology were assessed for the prevalence of peripheral vascular disease by measuring the Ankle-brachial index and Carotid intima-media thickness. Gender, smoking, hypertension, diabetes and ischemic heart disease profiles of the sample were analyzed for association with peripheral vascular disease. Majority of the patients belonged to the age group 40-50 years. 82 were males, of these 47 were smokers. 6 patients in the sample had symptoms suggestive of peripheral vascular disease. While 21%(n=19) of patients in the sample were diabetics and 21%(n=19) had evidence of ischemic heart disease, hypertension was present in 41%(n=37) of the patients. 50% of the patients belonged to CRF stage 4. The prevalence of the peripheral vascular disease, as determined by ABI<0.9, was 31.1%. CIMT thickness > 0.9mm has a positive correlation with CKD stages and has a statistically significant P value of <0.05. In conclusion, this study revealed that there is an increased prevalence of PVD in smokers, diabetics and in ischemic heart disease compared to those with hypertension.

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“…Pacientes com DAOP possuem pressão arterial sistólica (PAS) significativamente mais alta, e pressão arterial diastólica (PAD) e taxa de filtração glomerular significativamente menor (eGFR) do que aqueles sem DAOP. No entanto, fatores como duração do diabetes, IMC, HbA1c, lipoproteína de baixa densidade (LDL), lipoproteína de alta densidade (HDL) e níveis de triglicerídeos (TG) não são diferentes entre pacientes com ou sem DAOP (Herath et al, 2019). Além disso, outro Research, Society and Development, v. 12, n. 4, e25212441293, 2023 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i4.41293 achado importante é a associação significativa de DAOP assintomática com a deterioração da função renal, evidenciada pela redução da TFGe.…”

Section: Diagnóstico Por Métodos Laboratoriaisunclassified

“…A DAOP é uma manifestação de rigidez arterial associada ao início da doença renal crônica e a presença de TFGe baixa na triagem pode atuar como marcador clínico de doença macrovascular. (Herath et al, 2019).…”

Section: Diagnóstico Por Métodos Laboratoriaisunclassified

Análise dos métodos de diagnóstico da doença arterial obstrutiva periférica nos pacientes com Diabetes mellitus

Santana¹,

Mendes²,

Neto³

et al. 2023

RSD

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Objetivo: Sintetizar as informações acerca dos principais métodos para se realizar o diagnóstico da doença arterial obstrutivas nos pacientes com diabetes mellitus. Metodologia: Revisão integrativa de literatura que visa responder à pergunta norteadora originada da estratégia PICo "Como é feito o diagnóstico de DAOP em pacientes diabéticos?” com base em artigos selecionados nas plataformas MEDLINE/PubMed®, LILACS e WoS. Resultados: Para o diagnóstico de doença arterial obstrutiva nos diabéticos, o principal método clínico é o Índice Tornozelo Braquial, que se trata de uma técnica muito vantajosa pela sua sensibilidade, fácil execução e baixo custo. Ainda, entre os métodos laboratoriais, a osteoprotegerina apresenta níveis plasmáticos elevados nos pacientes em questão; já o peptídeo natriurético cerebral alto é indicado como um preditor; e há também a omentina, que é útil para acompanhamento e avaliação da gravidade. Além disso, como exame de imagem, a angiografia se apresenta como padrão ouro para esse reconhecimento, porém se trata de um método caro e invasivo, em contraponto, a ultrassonografia com Doppler é uma ferramenta prática e eficaz para predizer essa forma de complicação vascular. Conclusão: Foi possível sintetizar as principais descobertas clínicas e laboratoriais que podem ser examinadas durante o atendimento de pacientes com diabetes e que podem ser úteis para detectar a DAOP nesses indivíduos. Entretanto, é sugerido que mais estudos sejam conduzidos para explorar os novos métodos e sua eficácia, a fim de permitir um diagnóstico precoce e eficiente.

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Prevalence and associations of subclinical peripheral artery disease among patients with type 2 diabetes without clinical macrovascular disease

Cited by 5 publications

References 24 publications

Type 2 diabetes and the risk of cardiovascular events in peripheral artery disease versus coronary artery disease

Type 2 diabetes and the risk of cardiovascular events in peripheral artery disease versus coronary artery disease

A Study on Carotid Intima-Media Thickness and Ankle Brachial Index In Patients with Various Stages of Chronic Kidney Disease

Análise dos métodos de diagnóstico da doença arterial obstrutiva periférica nos pacientes com Diabetes mellitus

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