Preventive Therapies in Peripheral Arterial Disease

Shah, Aangi J.; Pavlatos, Nicholas; Kalra, Dinesh K.

doi:10.3390/biomedicines11123157

Cited by 3 publications

(2 citation statements)

References 135 publications

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“…In addition, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are emerging as an additional lipid-lowering therapy for patients with cardiovascular disease [ 79 , 80 ]. In a sub-analysis of the FOURIER trial, of a total of 27,654 participants up to the age of 85 years, 3642 patients had symptomatic PAD.…”

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

Piechocki,

Przewłocki,

Pieniążek

et al. 2024

JCM

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Background: Aging is a key risk factor for atherosclerosis progression that is associated with increased incidence of ischemic events in supplied organs, including stroke, coronary events, limb ischemia, or renal failure. Cardiovascular disease is the leading cause of death and major disability in adults ≥ 75 years of age. Atherosclerotic occlusive disease affects everyday activity, quality of life, and it is associated with reduced life expectancy. As most multicenter randomized trials exclude elderly and very elderly patients, particularly those with severe comorbidities, physical or cognitive dysfunctions, frailty, or residence in a nursing home, there is insufficient data on the management of older patients presenting with atherosclerotic lesions outside coronary territory. This results in serious critical gaps in knowledge and a lack of guidance on the appropriate medical treatment. In addition, due to a variety of severe comorbidities in the elderly, the average daily number of pills taken by octogenarians exceeds nine. Polypharmacy frequently results in drug therapy problems related to interactions, drug toxicity, falls with injury, delirium, and non-adherence. Therefore, we have attempted to gather data on the medical treatment in patients with extra-cardiac atherosclerotic lesions indicating where there is some evidence of the management in elderly patients and where there are gaps in evidence-based medicine. Public PubMed databases were searched to review existing evidence on the effectiveness of lipid-lowering, antithrombotic, and new glucose-lowering medications in patients with extra-cardiac atherosclerotic occlusive disease.

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Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

Piechocki,

Przewłocki,

Pieniążek

et al. 2024

JCM

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“…Lifestyle modifications, including regular exercise, weight loss, smoking cessation, and a heart-healthy diet, are cornerstone interventions for both conditions. Hemoglobin A1c levels less than 8 correlate favorably to improved outcomes [32]. Pharmacological management typically involves a multimodal approach.…”

Section: Management Strategiesmentioning

confidence: 99%

Hypertension in Patients With Peripheral Artery Disease: An Updated Literature Review

Abraham,

Mojaddedi,

Loseke

et al. 2024

Cureus

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Association between statin intensity and femoropopliteal stent primary patency in peripheral arterial disease

Seyferth,

Song,

Vance

et al. 2024

CVIR Endovasc

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Background Statins are widely used in coronary and peripheral arterial disease, but their impact on patency of stents placed for peripheral arterial disease is not well-studied. The purpose of this study was to evaluate femoropopliteal stent primary patency according to statin intensity at the time of stent placement and compare this effect to other covariates that may influence stent patency. Materials and methods A retrospective review identified 278 discrete femoropopliteal stent constructs placed in 216 patients over a 10-year period; Rutherford categories were 2 (3.6%), 3 (12.9%), 4 (21.2%), 5 (49.6%), and 6 (12.6%). Stent locations were common femoral (1.8%), common femoral/superficial femoral (0.7%), superficial femoral (50.7%), superficial femoral/popliteal (32.7%) and popliteal (14.0%) arteries; 63.3% of stents were paclitaxel-eluting. Primary patency of each stent construct was determined with duplex ultrasound, angiography, or computed tomographic angiography. Greater than 50% restenosis or stent occlusion was considered loss of patency. Cox proportional hazard and Kaplan–Meier modeling were used to assess the effect of statin use and additional covariates on stent patency. Results Patients on any statin at the time of stent placement were half as likely to undergo loss of primary unassisted patency as patients on no statin therapy (hazard ratio, 0.53; 95% confidence interval, 0.19–0.87; P = .004). Moderate/high intensity statin therapy conferred 17 additional months of median stent patency compared to the no statin group. Antiplatelet therapy, anticoagulant therapy, drug-eluting stents (versus bare metal or covered stents), and Rutherford class were not predictive of stent patency (P = 0.52, 0.85, 0.58, and 0.82, respectively). Conclusion Use of statin therapy at the time of femoropopliteal stent placement was the most predictive examined variable influencing primary unassisted patency.

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Preventive Therapies in Peripheral Arterial Disease

Cited by 3 publications

References 135 publications

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

Hypertension in Patients With Peripheral Artery Disease: An Updated Literature Review

Association between statin intensity and femoropopliteal stent primary patency in peripheral arterial disease

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