Differences in Cardiovascular Risk Factors Between Patients With Acute Limb Ischemia and Intermittent Claudication

Johner, Fabian; Thalhammer, Christoph; Jacomella, Vincenzo; Husmann, Marc; Amann-Vesti, Beatrice

doi:10.1177/0003319713487428

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…Since ALI is a drastic event for patients, their adherence to medication and control of cardiovascular risk factors might be better and explain, at least in part the low rate of events. Furthermore, ALI patients are significantly less often diabetics and smokers compared to patients presenting with intermittent claudication and might therefore have a smaller burden of generalised atherosclerosis, as recently reported by our group [6].…”

Section: Discussionsupporting

confidence: 72%

“…The reported short-term mortality of patients presenting with ALI was about 15 % to 20 %, depending on the outcome of the acute phase and comorbidities [5]. In a recent study, we compared claudicants and patients with ALI regarding cardiovascular risk factors [6]. We found that smoking, diabetes and coronary artery disease (CAD) are less prevalent in patients with ALI.…”

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort

Johner

Clemens

Husmann

et al. 2016

Vasa

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Summary: Background:We evaluated the long-term outcome after endovascular revascularisation for acute limb ischaemia (ALI). Patients and methods: From a prospectively maintained database, 318 endovascular interventions for ALI were identifi ed between 2004 and 2010. Event history and survival were analysed using the Kaplan-Meier method and Cox regression. Endpoints were target vessel revascularisation (TVR), non-target extremity revascularisation (NTER), amputation, major vascular events, coronary artery revascularisation and amputation-free survival. Results: Follow-up data of 303 patients (mean age 68.5 ± 12.7 years, 40 % female) were available. The mean follow-up time was 38.7 ± 26.2 months. TVR was performed in 40.1 ± 2.9 % at 1 year and 66.5 ± 3.8 % at 5 years. NTER at 1 and 5 years were 7.1 ± 1.5 % and 29.2 ± 4 %, respectively. The proportion of patients who needed major or minor amputation was 4.3 ± 1.2 % after 1 year and 9 ± 2.1 % after 5 years. Amputation-free survival at 1 year was 90.3 ± 1.8 % and 74.8 ± 3.2 % at 5 years. Coronary artery disease (HR 2.22, 95 % CI 1.33 to 3.7, p = 0.002) and atrial fi brillation (HR 2.56, % CI 1.3 to 5.04, p = 0.007) were independently associated with a worse amputation-free survival. The cumulative proportion surviving one year following acute limb ischemia was 95.4 ± 1.2 % and 79.7 ± 3.1 % after 5 years. Conclusions: Long-term amputation-free survival after successful revascularisation for ALI is high; negative predictors are coronary artery disease and atrial fi brillation.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort

Johner

Clemens

Husmann

et al. 2016

Vasa

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“…Recently, new approaches have also been tried: surgical treatment, such as percutaneous transluminal angioplasty (PTA) and revascularization; [8][9][10][11] use of autologous, stem and embryogenic cells for critical limb ischemia; 12,13 mixed surgical and pharmacological intervention, such as drug-eluting balloons; 8,14,15 new resorbable stent; 16 or promising extracorporeal shockwave therapy (ESW). 17 Medical treatments used for cardiovascular risk control, such as statins, might slightly contribute to ICD improvement.…”

Section: Introductionmentioning

confidence: 99%

Sulodexide improves pain-free walking distance in patients with lower extremity peripheral arterial disease: A systematic review and meta-analysis

Gaddi

Capello

Gheorghe‐Fronea

et al. 2020

JRSM Cardiovascular Disease

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Peripheral arterial disease is associated with very high cardiovascular risk. The main symptom is intermittent claudication, which strongly affects the quality of life. Therefore, treatment goals in peripheral arterial disease consist of the reduction of cardiovascular events and the relief of symptoms. An increase in pain-free walking distance, evaluated based on the Initial Claudication Distance, was also a strong positive prognostic factor in patients with peripheral arterial disease. Our objective was to reassess whether sulodexide is effective in improving Initial Claudication Distance. For this, we searched the literature according to the PRISMA checklist for double blind clinical trials assessing the improvement in the Initial Claudication Distance after 90 days of standard therapeutic regimen with sulodexide in adult patients with peripheral arterial disease. We found and assessed for bias in 11 studies eligible for review and meta-analysis. Data extracted from those studies favoured the sulodexide group, showing an overall difference in Initial Claudication Distance of þ68.9 (CI 95%; AE 11.9 m) at the end of treatment (p < 0.001). According to this review, sulodexide is effective in improving Initial Claudication Distance and consequently the quality of life in patients with peripheral arterial disease. Further studies are needed to assess the effects of this drug on disease progression in asymptomatic patients with peripheral arterial disease.

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“…CAD is reported to be concomitant in approx. About 40% to 80% of PAD patients with intermittent claudication . In this context it is of particular importance that PAD on its part is associated with increased severity of CAD as indicated by higher rate of multivessel and left main CAD .…”

Section: Introductionmentioning

confidence: 99%

“…About 40% to 80% of PAD patients with intermittent claudication. 16,17 In this context it is of particular importance that PAD on its part is associated with increased severity of CAD as indicated by higher rate of multivessel and left main CAD. 18,19 Heart failure is therefore more common in PAD and reduced left ventricular ejection fraction increased risk of major cardiovascular events in patients with intermittent claudication.…”

Section: Introductionmentioning

confidence: 99%

Unmet medical needs in intermittent Claudication with diabetes and coronary artery disease—A “real‐world” analysis on 21 197 PAD patients

Stalling

Engelbertz

Lüders³

et al. 2019

Clinical Cardiology

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Background Peripheral artery disease (PAD) is frequently co‐prevalent with coronary artery disease (CAD) and diabetes (DM). The study aims to define the burden of CAD and/ or DM in PAD patients at moderate stages and further to evaluate its impact on therapy and outcome. Methods Study is based on health insurance claims data of the BARMER reflecting an unselected “real‐world” scenario. Retrospective analyses were based on 21 197 patients hospitalized for PAD Rutherford 1‐3 between 1 January 2009 to 31 December 2011, including a 4‐year follow‐up (median 775 days). Results In PAD patients, CAD is prevalent in 25.3% (n = 5355), DM in 23.5% (n = 4976), and both CAD and DM in 8.2% (n = 1741). Overall, in‐hospital mortality was 0.4%, being increased if CAD was present (CAD alone: OR 1.849; 95%‐CI 1.066‐3.208; DM alone: OR 1.028; 95%‐CI 0.520‐2.033; CAD and DM: OR 3.115; 95%‐CI 1.720‐5.641). Both, CAD and DM increased long‐term mortality (CAD alone: HR 1.234; 95%‐CI 1.106‐1.376; DM alone: HR 1.260; 95%‐CI 1.125‐1.412; CAD and DM: HR 1.76; 95%‐CI 1.552‐1.995). DM further increased long‐term amputation risk (DM alone: HR 2.238; 95%‐CI 1.849‐2.710; DM and CAD: HR 2.199; 95%‐CI 1.732‐2.792), whereas CAD (alone) did not. Conclusions In a greater perspective, the data identify also mild to modest stage PAD patients at particular risk for adverse outcomes in presence of CAD and/or DM. CAD and DM both are related with a highly increased risk of long‐term mortality even in intermittent claudication, and DM independently increased amputation risk.

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Differences in Cardiovascular Risk Factors Between Patients With Acute Limb Ischemia and Intermittent Claudication

Cited by 4 publications

References 16 publications

Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort

Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort

Sulodexide improves pain-free walking distance in patients with lower extremity peripheral arterial disease: A systematic review and meta-analysis

Unmet medical needs in intermittent Claudication with diabetes and coronary artery disease—A “real‐world” analysis on 21 197 PAD patients

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