Epidemiology of peripheral artery disease in Europe: VAS Educational Paper

Olinic, Dan-Mircea; Spînu, Mihail; Olinic, Maria; Homorodean, Călin; Tătaru, Dan-Alexandru; Liew, Aaron; Schernthaner, Gerit‐Holger; Stanek, Agata; Fowkes, Gerry; Catalano, M.

doi:10.23736/s0392-9590.18.03996-2

Cited by 99 publications

(50 citation statements)

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“…Furthermore, the severity of PAD increases in patients with coexisting DM and it is associated with a higher rate of amputation in this group [6]. The risk of major amputation in patients with DM is five to ten times higher than in those without DM [7]. The prevalence of PAD in patients with DM over 40 years of age was estimated at 20% [8].…”

Section: Peripheral Arterial Disease In the Course Of Diabetesmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

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Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice.

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Section: Peripheral Arterial Disease In the Course Of Diabetesmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

Self Cite

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“…The association of PAD with coronary artery disease is observed in 50% of patients and in 20% of patients with cerebrovascular disease [25,26], becoming therefore an important indicator of the coexistence of other cardiovascular disorders [27]. Up to 40% of subjects with PAD die from coronary artery disease and 10-20% by cerebral artery disease [10].…”

Section: Risk Factorsmentioning

confidence: 99%

Prevalence of Peripheral Arterial Disease and Associated Vascular Risk Factors in 65-Years-Old People of Northern Barcelona

Gonçalves-Martins

Gil-Sala

Tello‐Díaz

et al. 2021

JCM

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Objective: To determine the prevalence and risk factors associated with peripheral arterial disease (PAD) in Northern Barcelona at 65 years of age. Methods: A single-center, cross-sectional study, including males and females 65 years of age, health care cardholders of Barcelona Nord. PAD was defined as an ankle–brachial index (ABI) < 0.9. Attending subjects were evaluated for a history of common cardiovascular risk factors. A REGICOR score was obtained, as well as a physical examination and anthropometric measurements. Results: From November 2017 to December 2018, 1174 subjects were included: 479 (40.8%) female and 695 (59.2%) male. Overall prevalence of PAD was 6.2% (95% CI: 4.8–7.6%), being 7.9% (95% CI: 5.9–9.9%) in males and 3.8% (95% CI: 2.1–5.5%) in females. An independent strong association was seen in male smokers and diabetes, with ORs pf 7.2 (95% CI: 2.8–18.6) and 1.8 (95% CI: 1.0–3.3), respectively, and in female smokers and hypertension, with ORs of 5.2 (95% CI: 1.6–17.3) and 3.3 (95% CI: 1.2–9.0). Male subjects presented with higher REGICOR scores (p < 0.001). Conclusion: Higher-risk groups are seen in male subjects with a history of smoking and diabetes and female smokers and arterial hypertension, becoming important subgroups for our primary healthcare centers and should be considered for ABI screening programs.

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“…Increased HbA1c level in diabetic patients also accounts for a 26% risk for PAD. (2) Diabetic patients with PAD are also at a 5-times higher risk of amputation. (32) Infection rates are higher in the diabetic patients and this can increase the possibility of amputation in the patients.…”

Section: Risk Factors Associated With the Development Of Chronic Limb Ischemiamentioning

confidence: 99%

“…The disease has affected more than 200 million people around the world and causes 12-15% mortality in Europe. (1,2) In the United States, the disease affects 1.3% of men and 1.7% of women (ages 40-49 years). The prevalence was significantly increased in the older population with 29.5% of men and 24.7% of women older than 80 years.…”

Section: Introductionmentioning

confidence: 99%

Chronic limb ischemia manifestation in COVID-19 infection: awareness and treatment in primary care

2021

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Chronic limb ischemia (CLI) is a type of peripheral arterial disease (PAD) that is still underdiagnosed and undertreated despite the increasing incidence, thus becoming a global health burden. And CLI reflects the local manifestations of a lethal systemic disease — atherosclerosis. If left untreated, chronic limb ischemia can result in major limb loss. In this pandemic era, limb ischemia has become one of several clinical manifestations that occur in patients with COVID-19 infection. Systemic inflammation in COVID-19 infection, direct viral infection, hypercoagulable state, and hyperinflammatory response are responsible for damage to the arterial system, causing endothelial dysfunction. Diagnosing PAD has become a challenge especially in the early stage and in the asymptomatic phase. The untreated condition could lead to the development of CLI. The primary physicians in the primary health facilities hold an important role in the early diagnosis and management of patients with CLI symptoms or with risk factors of CLI, especially in patients who have experienced COVID-19 infection. Due to the limitation of diagnostic testing modalities at primary health facilities, the physician can assess the ankle-brachial index (ABI) to determine the presence of CLI. Management of the disease is different for every patient and is customized based on the other comorbidities. Risk factors should be controlled in order to achieve a better outcome. A good management strategy will improve the quality of life of the patient. This review will discuss the occurrence of CLI in COVID-19 infection.

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Epidemiology of peripheral artery disease in Europe: VAS Educational Paper

Cited by 99 publications

References 0 publications

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Prevalence of Peripheral Arterial Disease and Associated Vascular Risk Factors in 65-Years-Old People of Northern Barcelona

Chronic limb ischemia manifestation in COVID-19 infection: awareness and treatment in primary care

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