scholarly journals Risk Factor Management in Non-Metropolitan Patients with Coronary and Peripheral Artery Disease – A Protocol of a Prospective, Multi-Center, Quality Improvement Strategy

2021 ◽  
Vol Volume 17 ◽  
pp. 267-272
Author(s):  
Claudia Zemmrich ◽  
Peter Bramlage ◽  
Philipp Hillmeister ◽  
Mesud Sacirovic ◽  
Ivo Buschmann
Keyword(s):  
Risk Factor ◽  
Quality Improvement ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Risk Factor Management ◽  
Artery Disease

scholarly journals Risk factors and clinical outcomes in chronic coronary and peripheral artery disease: An analysis of the randomized, double-blind COMPASS trial

2019 ◽  
Vol 27 (3) ◽  
pp. 296-307 ◽  
Author(s):  
Thomas Vanassche ◽  
Peter Verhamme ◽  
Sonia S Anand ◽  
Olga Shestakovska ◽  
Keith AA Fox ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peripheral Artery Disease ◽  
Low Dose ◽  
Cardiovascular Death ◽  
Peripheral Artery ◽  
Double Blind ◽  
Artery Disease ◽  
Risk Factor Status ◽  
Ischemic Events

Aims Secondary prevention in patients with coronary artery disease and peripheral artery disease involves antithrombotic therapy and optimal control of cardiovascular risk factors. In the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) study, adding low-dose rivaroxaban on top of aspirin lowered cardiovascular events, but there is limited data about risk factor control in secondary prevention. We studied the association between risk factor status and outcomes, and the impact of risk factor status on the treatment effect of rivaroxaban, in a large contemporary population of patients with coronary artery disease or peripheral artery disease. Methods and results We reported ischemic events (cardiovascular death, stroke, or myocardial infarction) in participants from the randomized, double-blind COMPASS study by individual risk factor (blood pressure, smoking status, cholesterol level, presence of diabetes, body mass index, and level of physical activity), and by number of risk factors. We compared rates and hazard ratios of patients treated with rivaroxaban plus aspirin vs aspirin alone within each risk factor category and tested for interaction between risk factor status and antithrombotic regimen. Complete baseline risk factor status was available in 27,117 (99%) patients. Status and number of risk factors were both associated with increased risk of ischemic events. Rates of ischemic events (hazard ratio 2.2; 95% confidence interval 1.8–2.6) and cardiovascular death (hazard ratio 2.0; 1.5–2.7) were more than twofold higher in patients with 4–6 compared with 0–1 risk factors ( p < 0.0001 for both). Rivaroxaban reduced event rates independently of the number of risk factors ( p interaction 0.93), with the largest absolute benefit in patients with the highest number of risk factors. Conclusion More favorable risk factor status and low-dose rivaroxaban were independently associated with lower risk of cardiovascular events.

The risk of peripheral artery disease in older adults - seven-year results of the getABI study

VASA ◽  
2016 ◽  
Vol 45 (5) ◽  
pp. 403-410 ◽  
Author(s):  
Dietmar Krause ◽  
Ina Burghaus ◽  
Ulrich Thiem ◽  
Ulrike S. Trampisch ◽  
Matthias Trampisch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Factor ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Density Lipoprotein ◽  
Current Smoker ◽  
Repeated Measurements ◽  
Peripheral Artery ◽  
Artery Disease

Abstract. Background: To assess the risk of peripheral artery disease (PAD) in older adults and the contribution of traditional and novel risk factors to the incidence of PAD. Patients and methods: 344 general practitioners (GPs), trained by vascular specialists all over Germany, enrolled 6,880 unselected participants aged 65 years or older (getABI study). The onset of PAD was determined by a regression method in the course of repeated measurements of the ankle brachial index (ABI) over seven years. PAD onset was defined by the declining linear regression ABI line reaching 0.9 or by PAD symptoms. Results: The cumulative PAD incidence over seven years was 12.9%, corresponding to an incidence rate of 20.3 per 1000 person years (95% confidence interval [95%CI] 18.8 to 21.7). Logistic regression analysis showed that traditional risk factors contributed significantly to the risk of PAD: current smoker status (odds ratio 2.65, 95%CI 2.08 to 3.37), diabetes (1.35, 95%CI 1.13 to 1.62), and low-density lipoprotein >130 mg/dl (1.26, 95%CI 1.07 to 1.48). Three novel risk factor candidates showed significant impact on PAD incidence: elevated sensitive C-reactive protein level (1.23, 95%CI 1.05 to 1.45), impaired estimated glomerular filtration rate (1.27, 95%CI 1.03 to 1.56), and elevated homocysteine level (1.19, 95%CI 1.01 to 1.41). Conclusions: Older adults in Germany have a PAD risk of 12.9% per seven years. Potentially modifiable traditional PAD risk factors yield high impact on PAD incidence. Novel risk factor candidates may contribute to the risk of PAD

scholarly journals Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi‐Cohort Study

2020 ◽  
Vol 9 (9) ◽  
Author(s):  
Katriina Heikkilä ◽  
Jaana Pentti ◽  
Ida E. H. Madsen ◽  
Tea Lallukka ◽  
Marianna Virtanen ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Peripheral Artery Disease ◽  
Job Strain ◽  
Peripheral Artery ◽  
Artery Disease

Significant prevalence of peripheral artery disease in patients with disturbed wound healing following elective foot and ankle surgery: Results from the ABI-PRIORY (ABI as a PRedictor of Impaired wound healing after ORthopedic surgerY) trial

2019 ◽  
Vol 25 (2) ◽  
pp. 118-123
Author(s):  
Arne M Müller ◽  
Andreas Toepfer ◽  
Norbert Harrasser ◽  
Bernhard Haller ◽  
Markus Walther ◽  
...  
Keyword(s):  
Wound Healing ◽  
Risk Factor ◽  
Peripheral Artery Disease ◽  
Wound Complications ◽  
Control Group ◽  
Foot And Ankle ◽  
Peripheral Artery ◽  
Impaired Wound Healing ◽  
Ankle Surgery ◽  
Artery Disease

Disturbed wound healing (DWH) following elective foot and ankle surgery is associated with a number of known risk factors. The purpose of this study was to determine if peripheral artery disease (PAD) is a potential risk factor that contributes to an increase in postoperative DWH. In a case–control study, we analyzed all patients undergoing elective foot and ankle surgery between January 1, 2014 and December 31, 2017 at two institutions and identified 51 patients with postoperative DWH. After matching with 51 control patients without DWH, all 102 patients were evaluated for PAD. The prevalence of PAD was significantly higher in the DWH group compared to the control group (41.2% vs 19.6%, p < 0.01). This difference was even more distinctive for patients with any abnormal ankle–brachial index (ABI) (51.0% vs 19.6%, p < 0.001). After adjustment for diabetes, hypertension, hypercholesterolemia, and smoking, any abnormal ABI or a history of PAD remained an independent risk factor for DWH (odds ratio 3.28; 95% CI 1.24–8.71). In this dual-center study, postoperative DWH was associated with significantly higher rates of PAD. These findings suggest that preoperative evaluation for PAD could be a helpful tool to identify patients at high risk for postoperative wound complications undergoing foot and ankle surgery. This trial is registered with drks.de, number DRKS00012580.

AST/ALT Ratio and Peripheral Artery Disease in a Chinese Hypertensive Population: A Cross-Sectional Study

Angiology ◽  
2021 ◽  
pp. 000331972110044
Author(s):  
Hui Liu ◽  
Xiaoyuan Zha ◽  
Congcong Ding ◽  
Lihua Hu ◽  
Minghui Li ◽  
...  
Keyword(s):  
Risk Factor ◽  
Peripheral Artery Disease ◽  
Reference Group ◽  
Cardiovascular Death ◽  
Cross Sectional Study ◽  
Peripheral Artery ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Increased Risk ◽  
Artery Disease

Previous studies reported that the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) was a risk factor in cardiovascular disease. Peripheral artery disease (PAD) is an important risk factor for cardiovascular death. However, only a few studies investigated the correlations between the AST/ALT ratio and PAD. We analyzed data from 10 900 patients with hypertension from the Chinese Hypertension Registry Study; 350 patients had PAD (prevalence 3.2%). After adjusting for potential confounders, the AST/ALT ratio was independently and positively associated with risk of PAD (OR: 1.31, 95% CI, 1.13-1.59), and a significant increased risk of PAD for the third AST/ALT ratio tertile (T3) compared with the first tertile (T1; OR: 1.49, 95% CI, 1.09-2.04, P trend = .005) was found. Moreover, when we combined T1 and T2 into one group and used it as a reference group, the risk of PAD increased with the increase in AST/ALT; the risk ratio was 1.52 (95% CI, 1.20-1.95). A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. Our results suggest that the AST/ALT ratio may help identify patients at high risk of vascular end points and might be a convenient, economical, and effective tool for evaluating the risk of atherosclerosis.

scholarly journals O72: SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE IN PERIPHERAL ARTERY DISEASE PATIENTS

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
ST Rashid ◽  
S Bangee
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Secondary Prevention ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Nice Guidelines ◽  
Novel Treatments ◽  
Wide Range ◽  
Artery Disease ◽  
Prevention Of Cardiovascular Disease

Abstract Introduction Peripheral artery disease (PAD) is associated with significant cardiovascular morbidity and mortality which can be reduced by the treatment of atherosclerotic risk factors. Recent research demonstrates that novel drugs can significantly enhance PAD outcomes. However, the uptake of these drugs is uncertain. We wished to audit current atherosclerotic management in PAD patients as well as their eligibility for newer drugs - PCSK 9 inhibitors, SGLT2 inhibitors, and DOAC drugs – in accordance with relevant guidelines and trials. Method 100 PAD inpatients and outpatients seen at a teaching hospital in the UK within the month of March 2019 were assessed. Medications from PAD patients were recorded from hospital records and patient histories were assessed for secondary prevention of cardiovascular disease - lipids, blood pressure, diabetic control, and atherothrombotic prevention. Result showed that compliance with NICE guidelines had a wide range – from 19% of outpatients on correct lipid control to 89% of inpatients on optimal atherothrombotic management. Based on the best evidence of eligibility: 0 of 41 eligible patients were taking PCSK9 Inhibitors, 1 out of the 71 was on an SGLT 2 inhibitor and 6 of 98 patients were on Rivaroxaban. Conclusion This audit shows adherence to NICE guidelines is variable for secondary prevention of atherosclerosis in PAD patients. Furthermore, very few novel treatments had been prescribed for suitable patients. Overall, prescribing for PAD risk factor management can be significantly improved. A solution could be dedicating risk factor clinics led by nurses, pharmacists or physicians. Take-home message Steps need to be taken to prevent cardiovascular disease in peripheral arterial disease patients. Steps include improvements in the following of guidelines, exploration of novel treatments, and the introduction of special risk factor clinics focused on improving the prognosis of the patients.

scholarly journals Peripheral Artery Disease as a Risk Factor for Myocardial Infarction

Cureus ◽  
2021 ◽  
Author(s):  
Erick Leonel Pérez Mejia ◽  
Sila Mateo Faxas ◽  
Nicole Tejeda Taveras ◽  
Abdul Subhan Talpur ◽  
Kumar Jitesh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Factor ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease
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