Update on peripheral artery disease: Epidemiology and evidence-based facts

Shu, Jun; Santulli, Gaetano

doi:10.1016/j.atherosclerosis.2018.05.033

Cited by 374 publications

(271 citation statements)

References 21 publications

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“…Peripheral artery disease (PAD) remains a main cause of non-traumatic lower limb amputations and is linked with cardiovascular complications and long-term disability in type 2 diabetes [1,2]. Early screening and interventions for modifiable risk factors for PAD can lead to reduction of risk and related complications.…”

Section: Introductionmentioning

confidence: 99%

Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes

Yang

Lin

et al. 2020

Cardiovasc Diabetol

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Background: This study investigated whether visit-to-visit fasting plasma glucose (FPG) variability, as measured by the coefficient of variation (CV), increased peripheral artery disease (PAD) risk.Methods: Individuals with type 2 diabetes from the National Diabetes Care Management Program during the period 2002-2004, ≥ 30 years of age, and free of PAD (n = 30,932) were included and monitored until 2011. Cox proportional hazards regression models were implemented to analyze related determinants of PAD.Results: A total of 894 incident cases of PAD were identified during an average 8.2 years of follow-up, resulting in a crude incidence rate of 3.53 per 1000 person-years. Both FPG-CV and HbA1c were significantly associated with PAD after multivariate adjustment, with corresponding hazard ratios of 1.24 [95% confidence interval (CI) 1.04-1.47] for FPG-CV in the third tertile and 1.50 (95% CI 1.10-2.04) for HbA1c ≥ 10%. The findings of the sensitivity analysis remained consistent after excluding potential confounders, demonstrating the consistency of the results. Conclusions:The associations between HbA1c, variability in FPG-CV, and PAD suggest a linked pathophysiological mechanism, suggesting the crucial role of glycemic variability in clinical management and therapeutic goals in preventing PAD in type 2 diabetes.

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Section: Introductionmentioning

confidence: 99%

Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes

Yang

Lin

et al. 2020

Cardiovasc Diabetol

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show abstract

“…Peripheral arterial disease (PAD) is a devastating disease in which atherosclerotic plaque buildup leads to a narrowing of peripheral arteries in the lower limb, manifesting as ischemic pain [1,2]. PAD affects more than 200 million patients worldwide, with 12 million people suffering from the disease in North America alone [3]. Common PAD symptoms include pain induced by walking which resolves at rest (claudication).…”

Section: Introductionmentioning

confidence: 99%

MicroRNA Profile of Patients with Chronic Limb-Threatening Ischemia

et al. 2020

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Chronic limb-threatening ischemia (CLTI) results in devastating complications such as lower-limb amputations. In this study, a genome-wide plasma microRNAs (miRNA) sequencing was performed to identify miRNA(s) associated with CLTI. Blood samples were collected from early stage CLTI patients (ABI < 0.9) and non-PAD controls (ABI ≥ 0.9) for 3 experiments: discovery phase (n = 23), confirmatory phase (n = 52) and validation phase (n = 20). In the discovery phase, next generation sequencing (NGS) was used to identify miRNA circulating in the plasma CLTI (n = 13) patients, compared to non-PAD controls (n = 10). Two down-regulated miRNAs (miRNA-6843-3p and miRNA-6766-5p) and three upregulated miRNAs (miRNA-1827, miRNA-320 and miRNA-98-3p) were identified (≥2-fold change). In the confirmatory phase, these 5 deregulated miRNAs were further investigated in non-PAD (n = 21) and CTLI (n = 31) patients using qRT-PCR. Only miRNA-1827 was found to be significantly upregulated (≥3-fold, p-value < 0. 001) in the CLTI group. Lastly, to minimize the influence of confounding factors, miRNA-1827 plasma levels were validated in a third cohort of CLTI patients (n = 10) matched to non-PAD controls (n = 10). Our analysis demonstrated that miRNA-1827 expression was increased in the CLTI cohort (≥2-folds, p-value < 0.001). In summary, circulating miRNA-1827 is significantly elevated in patients with CLTI.

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“…The prevalence of PAD increases with age and the number of vascular risk factors reaches up to 15-20% above the age of 70 years. Lower extremity PAD affects approximately 10% of the American population, with 30 to 40% of these patients presenting with claudication symptoms [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Concomitant chronic venous insufficiency in patients with peripheral artery disease: insights from MR angiography

et al. 2020

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Objectives The clinical presentation of peripheral artery disease (PAD) and chronic venous insufficiency (CVI) can overlap and the conditions may co-exist. The purpose of our study was to investigate the prevalence and clinical significance of concomitant CVI in patients with PAD examined with runoff MR angiography (MRA). Methods We analysed 180 patients (median age 69 years, range 27 to 91) with known or suspected PAD who underwent MRA at our institution between 2012 and 2018. MRA datasets were re-evaluated for manifestations of CVI. Electronic charts were reviewed to analyse whether diagnosis of CVI was documented and to determine Fontaine stage of PAD. Results Evidence of possible CVI on MRA was found in 38 (21%) patients. Only seven (18%) of these patients had a documented diagnosis of CVI. Patients with co-existing PAD and CVI were more likely obese (median BMI 29.7 vs. 26.3 kg/m 2 , p = 0.001) and diabetic (55 vs. 35%, p = 0.039) than patients without CVI. The frequency of concomitant CVI manifestations decreased from distal to proximal with the lower leg affected in all 38 patients and the thigh in 17 patients (45%). Patients with co-existing PAD and CVI were more likely to have a clinical diagnosis of stage IV PAD than patients without co-existing CVI (57% vs. 34%, relative risk 1.68, p = 0.018). Conclusions Signs of possible concomitant CVI can be seen in approximately one-fifth of patients with known or suspected PAD examined with runoff MRA. If present, these findings should be reported since CVI may mimic or contribute to symptoms attributed to PAD. Key Points • In total, 21% of patients with PAD patients examined with MR angiography show signs of possible co-existing CVI. • Patients with co-existing CVI were 1.7-fold more likely to have a clinical diagnosis of stage IV PAD. • Our data also showed that co-existing chronic venous insufficiency is under-diagnosed in patients with PAD. Keywords Magnetic resonance angiography. Venous insufficiency. Peripheral artery disease Abbreviations CVI Chronic venous insufficiency MRA Magnetic resonance angiography PAD Peripheral artery disease TWIST Time-resolved angiography with interleaved stochastic trajectories

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Update on peripheral artery disease: Epidemiology and evidence-based facts

Cited by 374 publications

References 21 publications

Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes

Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes

MicroRNA Profile of Patients with Chronic Limb-Threatening Ischemia

Concomitant chronic venous insufficiency in patients with peripheral artery disease: insights from MR angiography

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