Two-year Outcome of Quality of Life and Health Status for the Elderly with Chronic Limb-threatening Ischemia

Peters, Chloé M.L.; Lodder, Paul; Vries, Jolanda De; Veen, Eelco J.; Groot, Hans G.W. de; Ho, Gwan H.; Laan, Lijckle van der

doi:10.2147/cia.s272078

Cited by 11 publications

(13 citation statements)

References 39 publications

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“…Of 6470 records identified in the primary database search, 114 studies25–138 were included. An additional 16 studies139–154 were included from the secondary database search and 16 studies155–170 from the reference list search.…”

Section: Resultsmentioning

confidence: 99%

Measuring Quality of Life in Chronic Limb-threatening Ischemia Patients and Informal Carers: A Scoping Review

et al. 2022

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Objective: To review quality of life (QOL) instruments for chronic limb-threatening ischemia (CLTI) patients and informal carers, and their use in QOL and cost-utility analysis (CUA) studies. Background: CLTI is a global health problem with significant morbidity affecting patients and informal carers. QOL is increasingly measured for holistic outcomes assessment and CUA. However, measurement instruments in CLTI are poorly understood. Methods: MEDLINE, EMBASE, PsycINFO, CINAHL, COSMIN, PROQOLID, CEA registry, and NHS EED databases were searched for all English language studies up to May 2021. Features of instruments, evidence of measurement property appraisal, and trends in use were assessed. Prospective protocol registration (Open Science Framework: https://doi.org/10.17605/OSF.IO/KNG9U). Results: A total of 146 studies on QOL instruments (n=43), QOL outcomes (n=97), and CUA (n=9) were included. Four disease-specific QOL instruments are available for lower extremity arterial disease (intermittent claudication or CLTI). VascuQoL-25 and VascuQoL-6 have been used in CLTI. There is no CLTI-specific instrument. Of 14 generic instruments, SF-36, EQ-5D-3L, NHP, and WHOQOL-BREF were most common. Studies reporting partial measurement property appraisal favored VascuQoL-25, VascuQoL-6, and SF-36. Feasibility considerations include mode of administration and responder burden. None of 4 available carer-specific instruments have been used in CLTI. Since 1992, the number of QOL studies has increased considerably, but CUA studies are scarce. Informal carers have not been assessed. Conclusions: This review provides a comprehensive reference for QOL measurement in CLTI that helps end-users with instrument selection, use, and interpretation. However, a CLTI-specific instrument is needed. There is an opportunity to benefit society through future CUA studies and evaluation of QOL in informal carers.

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Section: Resultsmentioning

confidence: 99%

Measuring Quality of Life in Chronic Limb-threatening Ischemia Patients and Informal Carers: A Scoping Review

et al. 2022

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“… 7–9 Furthermore, CLTI is both more prevalent and more severe in older people. 1 , 5 , 7 , 10 With the rapidly ageing population, the incidence of CLTI is expected to increase. This will have an impact on the functional and cognitive outcome and the Quality of Life (QoL) of the older vascular surgical population and will contribute to the rise of healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

Multicomponent Prehabilitation as a Novel Strategy for Preventing Delirium in Older Chronic Limb Threatening Ischemia Patients: A Study Protocol

Meulenbroek¹,

Faes²,

Mil³

et al. 2022

CIA

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Objective Chronic limb threatening ischemia is the final stage of peripheral arterial disease. Current treatment is based on revascularization to preserve the leg. In the older, hospitalized chronic limb threatening ischemia patient, delirium is a frequent and severe complication after revascularization. Delirium leads to an increased length of hospital stay, a higher mortality rate and a decrease in quality of life. Currently, no specific guidelines to prevent delirium in chronic limb threatening ischemia patients exist. We aim to evaluate the effect of a multicomponent, multidisciplinary prehabilitation program on the incidence of delirium in chronic limb threatening ischemia patients ≥65 years. Design A prospective observational cohort study to investigate the effects of the program on the incidence of delirium will be performed in a large teaching hospital in the Netherlands. This manuscript describes the design of the study and the content of this specific prehabilitation program. Methods Chronic limb threatening ischemia patients ≥65 years that require revascularization will participate in the program. This program focuses on optimizing the patient’s overall health and includes delirium risk assessment, nutritional optimization, home-based physical therapy, iron infusion in case of anaemia and a comprehensive geriatric assessment in case of frailty. The primary outcome is the incidence of delirium. Secondary outcomes include quality of life, amputation-free survival, length of hospital stay and mortality. Exclusion criteria are the requirement of acute treatment or patients who are mentally incompetent to understand the procedures of the study or to complete questionnaires. A historical cohort from the same hospital is used as a control group. Discussion This study will clarify the effect of a prehabilitation program on delirium incidence in chronic limb threatening ischemia patients. New insights will be obtained on optimizing a patient’s preoperative mental and physical condition to prevent postoperative complications, including delirium. Trial This protocol is registered at the Netherlands National Trial Register (NTR) number: NL9380.

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“…Застосування карнітин-аргінінової суміші обґрунтовували тим, що L-карнітин є одним із відомих кардіометаболічних препаратів з широким спектром дії [7], який відіграє важливу роль в енергетичному обміні у міокарді за рахунок транспортування і β-окислення ненасичених жирних кислот в мітохондріях [8,9], позитивно впливає на скоротливу функцію міокарда [10,11,12], а L-аргінін є субстратом для синтезу оксиду азоту (NO) в ендотеліоцитах, зниження біодоступністі якого (NO) часто спостерігається при цукровому діабеті, ожирінні та артеріальній гіпертензії.…”

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Correction of Insulin Resistance in Obese Patients With Myocardial Infarction and Comorbid Metabolic Syndrome

Швед

2022

Scientific and practical journal

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Objective. Insulin resistance (IR) is playing an essential role in the development of cardiovascular disease and has an adverse prognostic effect on the course of acute myocardial infarction (AMI) as a result of direct proatherogenic effects of IR and an adverse effect on myocardial contractility. The aim of the study was to evaluate the insulin resistance effects of multimodality therapy with dapagliflozin (Forxiga) and L-arginine/L-carnitine combination in overweight and obese patients with myocardial infarction. The aim of the study: to evaluate the insulin resistance effects of multimodality therapy with dapagliflozin (Forxiga) and L-arginine/L-carnitine combination in overweight and obese patients with myocardial infarction. Methods. The study enrolled 85 males with acute myocardial infarction with ST segment elevation; among these, there were 24 overweight patients (BMI within 25–29.9 kg/m2) and 36 patients with obesity (BMI >30 kg/m2). Normal body weight (BMI within 18–24.9 kg/m2) was documented in 25 study patients. The age of study subjects in the groups was 58.62±7.02 years on average. All patients were receiving standard of care treatment according to the protocols of the MoH of Ukraine [8]. Depending on the treatment program used, all patients were divided into three groups: Group 1 enrolled 25 patients who were receiving standard of care per-protocol treatment; Group 2 (test group) enrolled 28 patients where standard of care per-protocol treatment of MI was appended with L-arginine/L-carnitine combination (“TIVOR-L” by Yuria-Pharm Ltd.; marketing authorization No. UA/15067/01/01) as intravenous infusions for seven days at 100.0 ml once a day; Group 3 (test group) enrolled 32 patients who received dapagliflozin (10 mg/day) in addition to combination therapy (per-protocol treatment + L-arginine/L-carnitine combination). Control group enrolled 20 virtually healthy volunteers without cardiovascular disease. The presence of IR was assessed using HOMA-IR index. The severity of IR was determined based on the magnitude of the IR factor according to F. Caro. The patients were considered to have IR if the following criteria were met: HOMA > 2.77 and Caro index < 0.33; i.e. the higher the HOMA index and the lower the Caro index, the lower was the tissue sensitivity to insulin and the greater was the IR. Statistical analysis of study findings was performed using Statistica 10.0 package of statistical software and Microsoft Excel 2019. Results. Overweight and obese patients with MI + MS develop carbohydrate metabolism disorders, which are manifested by hyperglycemia, increased HOMA index and decreased Caro index. Insulin resistance is the main cause of the above disorders. The severity of insulin resistance was increasing in the presence of excessive body and obesity, as suggested by a significant reduction in Caro index. It is the presence of IR and carbohydrate metabolism disorders that contributed to the development of systolic-diastolic dysfunction of the myocardium in patients with ACS (MI). Conclusions. At baseline, overweight and obese patients with myocardial infarction develop a pronounced insulin resistance with carbohydrate metabolism disorders and reduced systolic-diastolic function of the heart. Multi-modality treatment with inclusion of L-carnitine/L-arginine combination and dapagliflozin in overweight and obese patients with myocardial infarction facilitated restoration of tissue sensitivity to insulin and improved carbohydrate metabolism and systolic-diastolic function of the heart in such comorbid patients.

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Two-year Outcome of Quality of Life and Health Status for the Elderly with Chronic Limb-threatening Ischemia

Cited by 11 publications

References 39 publications

Measuring Quality of Life in Chronic Limb-threatening Ischemia Patients and Informal Carers: A Scoping Review

Measuring Quality of Life in Chronic Limb-threatening Ischemia Patients and Informal Carers: A Scoping Review

Multicomponent Prehabilitation as a Novel Strategy for Preventing Delirium in Older Chronic Limb Threatening Ischemia Patients: A Study Protocol

Correction of Insulin Resistance in Obese Patients With Myocardial Infarction and Comorbid Metabolic Syndrome

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