Impact of cardiovascular risk factors on severity of peripheral artery disease

Wyss, Thomas R.; Adam, Luise; Haynes, Alan G.; Kucher, Nils; Silbernagel, Günther; Do, Dai-Do; Schmidli, Jürg; Baumgartner, Iris

doi:10.1016/j.atherosclerosis.2015.07.002

Cited by 16 publications

(14 citation statements)

References 26 publications

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“…25 Patients' age is also a significant risk factor influencing the long-term clinical outcomes in patients with CLI. 26,27 According to our findings, the high comorbidity burden taking into account the age factor (Age-CCI > 5) was associated with the negative clinical dynamics one year after SCS. Furthermore, clinical manifestations of CLI by the time SCS is performed also have an effect on the long-term outcomes.…”

Section: Discussionmentioning

confidence: 50%

The Clinical Outcomes in Patients with Critical Limb Ischemia One Year after Spinal Cord Stimulation

Клинкова

Kamenskaya

Ashurkov

et al. 2020

Annals of Vascular Surgery

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Section: Discussionmentioning

confidence: 50%

The Clinical Outcomes in Patients with Critical Limb Ischemia One Year after Spinal Cord Stimulation

Клинкова

Kamenskaya

Ashurkov

et al. 2020

Annals of Vascular Surgery

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“…Our observations are consistent with the study of Oozawa and collaborators, conducted in smaller population where few diabetic patients were compared to healthy controls, instead of T2D patients [ 29 ]. Our choice to investigate only diabetic patients has been suggested by the evidence that diabetes is one of the strongest predictor for critical limb ischemia occurrence [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Serum high mobility group box-1 and osteoprotegerin levels are associated with peripheral arterial disease and critical limb ischemia in type 2 diabetic subjects

Giovannini

Tinelli

Biscetti

et al. 2017

Cardiovasc Diabetol

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BackgroundHigh mobility group box-1 (HMGB-1) is a nuclear protein also acting as inflammatory mediator, whilst osteoprotegerin (OPG), member of tumor necrosis factor receptor superfamily, is indicated as marker of vascular calcification. Peripheral artery disease (PAD) and type 2 diabetes (T2D) are clinical conditions characterized by elevated serum inflammatory markers and vascular calcification enhancement. The aim of this study was to investigate the potential role of HMGB-1, OPG and several inflammatory mediators such as C-reactive protein (HsCRP), tumor necrosis factor-alpha and interleukin-6 (IL-6) on the presence and severity of peripheral artery disease in patients with T2D.MethodsIn this retrospective observational study, we have analyzed HMGB-1, OPG and inflammatory cytokines serum levels in 1393 type 2 diabetic patients with PAD and without PAD (WPAD).ResultsHMGB-1 (7.89 ± 15.23 ng/mL), OPG (6.54 ± 7.76 pmol/L), HsCRP (15.6 ± 14.4 mg/L) and IL-6 (56.1 ± 28.6 pg/mL) serum levels were significantly higher in patients with PAD than in those WPAD (3.02 ± 8.12 ng/mL, P ˂ 0.001; 2.98 ± 2.01 pmol/L, P < 0.001; 7.05 ± 4.4 mg/L, P < 0.001; 37.5 ± 20.2 pg/mL, P < 0.001 respectively). Moreover HMGB-1 (P < 0.001), OPG (P < 0.001), HsCRP (P < 0.001) and IL-6 (P < 0.001) serum levels were positively correlated with clinical severity of PAD. HMGB-1 (adjusted OR 12.32; 95% CI 3.56–23.54, P = 0.023) and OPG (adjusted OR 3.53; 95% CI 1.54–6.15, P = 0.019) resulted independent determinants of PAD in patients with T2D after adjusting for the conventional cardiovascular risk factor and established inflammatory mediators.ConclusionsIn T2D patients HMGB-1 and OPG serum levels are higher in patients affected by PAD and independently associated with its occurrence and clinical severity.

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“…A vast majority of PAD patients is at subclinical stages of the disease, yet at significant risk of cardiovascular events . Particularly the combination of diabetes mellitus (DM) and coronary artery disease (CAD) promotes development and progression of PAD . Both, CAD and DM are linked in a complex manner with PAD outcome …”

Section: Introductionmentioning

confidence: 99%

“…3 Particularly the combination of diabetes mellitus (DM) and coronary artery disease (CAD) promotes development and progression of PAD. 2,[4][5][6] Both, CAD and DM are linked in a complex manner with PAD outcome. [5][6][7][8][9] Particularly lower limb calcification as mainly prevalent in DM patients is associated with increased cardiac mortality and morbidity.…”

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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Impact of cardiovascular risk factors on severity of peripheral artery disease

Abstract: Conclusions:In peripheral artery disease patients undergoing first-time endovascular treatment, age, male gender, diabetes, and renal insufficiency were the strongest predictors for the presence of critical limb ischaemia.

Cited by 16 publications

References 26 publications

The Clinical Outcomes in Patients with Critical Limb Ischemia One Year after Spinal Cord Stimulation

The Clinical Outcomes in Patients with Critical Limb Ischemia One Year after Spinal Cord Stimulation

Serum high mobility group box-1 and osteoprotegerin levels are associated with peripheral arterial disease and critical limb ischemia in type 2 diabetic subjects

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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