Epidemiology of Peripheral Artery Disease and Polyvascular Disease

Aday, Aaron W.; Matsushita, Kunihiro

doi:10.1161/circresaha.121.318535

Cited by 224 publications

(103 citation statements)

References 140 publications

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“…Lower extremity arterial disease is a frequent manifestation of atherosclerosis that is estimated to affect more than 200 million people worldwide, of whom nearby 40 million are living in Europe. In the United States, 8.5 million people above the age of 40 years suffer from PAD, which is associated with significantly increased morbidity, mortality, and quality of life impairment [ 1 , 33 , 34 ]. The total number of individuals affected by PAD increased by 23% in the last 10 years as a result of population growth, global ageing of the population, increased incidence of DM worldwide and of smoking particularly in low- and middle-income countries [ 1 , 5 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus and Its Impact on Patient-Profile and In-Hospital Outcomes in Peripheral Artery Disease

Keller

Schmitt

Vosseler

et al. 2021

JCM

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Background: In patients with peripheral artery disease (PAD), the impact of diabetes mellitus (DM) on patient-profile and adverse in-hospital events is not well investigated. Methods: The German nationwide inpatient sample 2005–2019 was used for this analysis. Hospitalized PAD patients were stratified for DM and the influence of DM on patient-profile and adverse in-hospital events was investigated. Results: Our study comprised 2,654,871 hospitalizations (54.3% aged ≥70 years, 36.7% females) of patients with PAD in Germany 2005–2019. Among these, 864,691 (32.6%) patients had DM and 76,716 (2.9%) died during hospitalization. Diabetic PAD patients revealed an aggravated cardiovascular profile (Charlson Comorbidity Index: 6.0 (5.0–8.0) vs. 4.0 (3.0–5.0), p < 0.001). PAD patients with DM showed a higher rate of in-hospital mortality (3.5% vs. 2.6%, p < 0.001), as well as major adverse cardiovascular and cerebrovascular events (MACCE, 4.7% vs. 3.3%, p < 0.001) and had more often operated with amputation surgery (16.4% vs. 9.1%, p < 0.001). DM was an independent predictor of in-hospital mortality (OR 1.077 (95%CI 1.060–1.093), p < 0.001) and MACCE (OR 1.118 (95%CI 1.103–1.133), p < 0.001). In addition, amputations were also associated with DM (OR 1.804 (95%CI 1.790–1.818)), p < 0.001). Conclusions: DM is associated with an unfavorable clinical patient-profile and higher risk for adverse events in PAD patients, including substantially increased in-hospital mortality as well as MACCE rate, and were more often associated with amputation surgeries.

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Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus and Its Impact on Patient-Profile and In-Hospital Outcomes in Peripheral Artery Disease

Keller

Schmitt

Vosseler

et al. 2021

JCM

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“…A systematic review showed that half of PAD cases are due to smoking (5). Compared with non-smokers, people who have ever smoked are still at higher risk of developing PAD (6,7). Meanwhile, passive smoking also increases the risk of vascular damage or the diagnosis of PAD (8).…”

Section: Clinical Evidence Of Smoking-associated Padmentioning

confidence: 99%

Smoking and the Pathophysiology of Peripheral Artery Disease

Wang

Zhao

Geng

et al. 2021

Front. Cardiovasc. Med.

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Smoking is one of the most important preventable factors causing peripheral artery disease (PAD). The purpose of this review is to comprehensively analyze and summarize the pathogenesis and clinical characteristics of smoking in PAD based on existing clinical, in vivo, and in vitro studies. Extensive searches and literature reviews have shown that a large amount of data exists on the pathological process underlying the effects of cigarette smoke and its components on PAD through various mechanisms. Cigarette smoke extracts (CSE) induce endothelial cell dysfunction, smooth muscle cell remodeling and macrophage phenotypic transformation through multiple molecular mechanisms. These pathological changes are the molecular basis for the occurrence and development of peripheral vascular diseases. With few discussions on the topic, we will summarize recent insights into the effect of smoking on regulating PAD through multiple pathways and its possible pathogenic mechanism.

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“…Falanga et al documented delivering autologous BM-MSCs topically using fibrin spray. The cells remained viable and could migrate to the wound after application, showing promising results in both acute and chronic wounds [ 140 ]. A case report of a thermal burn patient, mostly full-thickness, showed increased wound healing with no hypertrophic scars after autologous administration of amniotic and hUC-MSCs [ 141 ].…”

Section: Wound Healingmentioning

confidence: 99%

Modulation of Mesenchymal Stem Cells for Enhanced Therapeutic Utility in Ischemic Vascular Diseases

Elshaer

Bahram

Rajashekar

et al. 2021

IJMS

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Mesenchymal stem cells are multipotent stem cells isolated from various tissue sources, including but not limited to bone marrow, adipose, umbilical cord, and Wharton Jelly. Although cell-mediated mechanisms have been reported, the therapeutic effect of MSCs is now recognized to be primarily mediated via paracrine effects through the secretion of bioactive molecules, known as the “secretome”. The regenerative benefit of the secretome has been attributed to trophic factors and cytokines that play neuroprotective, anti-angiogenic/pro-angiogenic, anti-inflammatory, and immune-modulatory roles. The advancement of autologous MSCs therapy can be hindered when introduced back into a hostile/disease environment. Barriers include impaired endogenous MSCs function, limited post-transplantation cell viability, and altered immune-modulatory efficiency. Although secretome-based therapeutics have gained popularity, many translational hurdles, including the heterogeneity of MSCs, limited proliferation potential, and the complex nature of the secretome, have impeded the progress. This review will discuss the experimental and clinical impact of restoring the functional capabilities of MSCs prior to transplantation and the progress in secretome therapies involving extracellular vesicles. Modulation and utilization of MSCs–secretome are most likely to serve as an effective strategy for promoting their ultimate success as therapeutic modulators.

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Epidemiology of Peripheral Artery Disease and Polyvascular Disease

Cited by 224 publications

References 140 publications

Diabetes Mellitus and Its Impact on Patient-Profile and In-Hospital Outcomes in Peripheral Artery Disease

Diabetes Mellitus and Its Impact on Patient-Profile and In-Hospital Outcomes in Peripheral Artery Disease

Smoking and the Pathophysiology of Peripheral Artery Disease

Modulation of Mesenchymal Stem Cells for Enhanced Therapeutic Utility in Ischemic Vascular Diseases

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