IMPACT OF DIABETES MELLITUS ON SEVERITY OF CONCOMITANT PERIPHERAL ARTERIAL OCCLUSIVE DISEASE IN PATIENTS WITH CORONARY ARTERY DISEASE

2005 ◽  
Vol 60 (3) ◽  
pp. 129-134
Author(s):  
N. Papanas ◽  
D. Tziakas ◽  
E. Maltezos ◽  
A. Kekes ◽  
E. Hatzinikolaou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Occlusive Disease ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Artery Disease ◽  
Peripheral Arterial

Cost-Effective Strategies for the Management of Vascular Disease

1997 ◽  
Vol 2 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Jeffrey A West
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cost Effectiveness ◽  
Coronary Artery ◽  
Peripheral Arterial Occlusive Disease ◽  
Cost Effectiveness Analysis ◽  
Arterial Occlusive Disease ◽  
Effectiveness Analysis ◽  
Artery Disease ◽  
Peripheral Arterial

Cardiovascular disease accounts for over 950 000 deaths and an estimated $151 billion in direct and indirect costs. Because of this escalating clinical and financial burden, economic analysis has become essential for the evaluation of preventative therapies for vascular disease. Economic analysis compares competing interventions or management strategies for costs and benefits; more specifically, cost-effectiveness analysis compares cost in financial terms like dollars to measures of effectiveness like years of life saved. Important concepts in the creation of a valid cost-effectiveness analysis include perspective, time horizon, measurement of costs and effectiveness and sensitivity analysis. In patients with peripheral arterial occlusive disease, most morbidity and mortality arises from complications of coronary artery disease. Because coronary artery disease and peripheral arterial occlusive disease commonly occur together and share risk factors, pathophysiology and response to preventative therapy, economic evaluations of preventative therapies for coronary artery disease have relevance for patients with vascular disease. Cost-effectiveness analysis reveals that modification of vascular risk factors like tobacco use, hypertension and hypercholesterolemia improve clinical outcomes at acceptable cost-effectiveness ratios, usually less than $20 000 per year of life saved. More importantly, interventions like smoking cessation or lipid modification in high-risk groups may be cost saving, with treatment costs outweighed by financial benefits. From the patient, clinician and societal perspective, cost-effectiveness analysis supports the aggressive modification of cardiovascular risk factors in patients with peripheral arterial occlusive disease.

scholarly journals Ankle Peak Systolic Flow Velocity (PSV) with Coronary Artery Disease in Diabetes Mellitus

2021 ◽  
pp. 273-278
Author(s):  
Archana Bhat ◽  
Krishna Kiran Karanth ◽  
Pradeep Periera
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Flow Velocity ◽  
Peak Systolic Velocity ◽  
Anterior Tibial Artery ◽  
Vessel Disease ◽  
Tibial Artery ◽  
Artery Disease ◽  
Peripheral Arterial

Introduction: Ankle peak systolic flow velocity can measure peripheral arterial blood flow which can predict extent of peripheral arterial disease. Atherosclerosis is more common in patients with diabetes mellitus and can affect simultaneously coronary circulation and peripheral circulation. Aims and Objectives: The primary objective of the study was to determine the occurrence of peripheral vascular disease by ankle Peak Systolic Velocity (PSV) in patients admitted for coronary artery disease with diabetes mellitus .The secondary objective was to see the association between the ankle Peak Systolic Flow Velocity (PSV) with the extent of abnormality of coronary angiogram in diabetic patients. Materials and Methods: All patients admitted in the hospital with coronary artery disease with diabetes mellitus in whom coronary angiogram was done were included in the study over a period of one year Presence of significant vessel disease CAD was defined as at least >70 % stenosis at one or more major coronary arteries (left anterior descending, left circumflex and right coronary artery). Ankle Peak Systolic Velocity (PSV) was measured in all patients by the Duplex method. The peak systolic velocities in the distal posterior tibial artery and the distal anterior tibial artery was measured and the average peak systolic velocities within three cardiac cycles6 was recorded by the radiologist. The ankle peak systolic flow above 40cm/s was considered as good flow in the lower limb extremity [7]. The data was analysed using SPSS version 17.0 software and mean and standard deviation was used . Results: Out of the cases studied 24 patients (80%) were males and 6 patients (20%) were females. All the Coronary angiograms was classified to single 13(43.3%), double 8(26.7%) and triple 9 (30%) vessel disease by the cardiologist. Out of the 13 patients with single vessel disease 3 patients had < 40 cm/s flow in the right anterior tibial artery and 10 patients had >40 cm/s flow in the right tibial artery indicating good perfusion.Out of the 8 patients with double vessel disease 4 patients had flow <40 cm/s and 4 patients had flow >40 cm/s. In triple vessel disease category 5 patients had flow <40 cm/s and 4 patients had flow>40cm/s. The p value was 0.2 was not significant and the chi square was 2.79 Similar results were obtained while compared with left ankle peak systolic flow velocity. Conclusion: In this study patients with single vessel disease have higher ankle peak systolic velocity though statistically not significant. Lower ankle peak systolic flow velocity corroborates with peripheral arterial disease [12] and is seen in patients with coronary artery disease [13].

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