Medical therapy for peripheral arterial disease

Simmons, Ashley; Steffen, Kelly; Sanders, Sarah

doi:10.1097/hco.0b013e328357428a

Cited by 19 publications

(22 citation statements)

References 66 publications

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“…Atherosclerotic process is characterized by combination of different morphological, histological and hemorheological changes in the arteries. Contrary to the common belief, atherosclerotic process can begin already at a young age and remain asymptomatic for a long period [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the development of direct anti-atherosclerosis therapy is necessary to induce regression of the existing atherosclerotic lesions and prevent their de novo formation. Despite the large amount of data from basic and clinical studies, no existing drugs were proven effective for the treatment of existing plaques, lowering the volume of lipid necrotic core and stabilizing the fibrous cap simultaneously [1][2][3][4][5][6][7][8][9]. Modern anti-atherosclerotic drugs can be divided into 2 big groups: statins (inhibitors of hydroxymethylglutaryl-coenzyme A reductase) and calcium antagonists.…”

Section: Introductionmentioning

confidence: 99%

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Blood Serum Atherogenicity: Cellular Test for the Development of Anti- Atherosclerotic Therapy

Myasoedova

Ivashinnikova²,

Собенин

et al. 2017

CPD

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Atherosclerosis is one of the main problems in modern medical practice. This multifactorial disease can remain asymptomatic for a long time before manifesting itself in cardiovascular disorders, causing ischemic heart disease, myocardial infarction and even sudden death. Many synthetic drugs have been developed to reduce the symptoms of atherosclerosis, however, their efficacy in terms of reduction of atherosclerotic lesions progression is a matter of debate. Adverse effects of the exiting therapy should also be taken into account. The development of cellular models and improved understanding of the mechanisms of atherogenesis at the vascular wall level helped establishing the "direct anti-atherosclerosis therapy" approach. In this approach, the decrease of intracellular lipid deposition and atherogenicity of human blood serum are considered primary (direct) antiatherosclerotic effects. Screening of synthetic and natural substances for anti-atherosclerotic activity revealed a number of botanicals that could be used for direct anti-atherosclerotic therapy to treat early-stage atherosclerosis. As a result, 3 novel non-pharmaceutical products were developed (Allicor, Inflaminat and Karinat). Studies on in vitro and ex vivo models of atherogenesis confirmed their anti-atherosclerotic and anti-atherogenic activities and safety in patients. Clinical studies of Allicor, Inflminat and Karinat were carried out in subjects with diagnosed early stage atherosclerosis, demonstrating a clinically significant anti-atherosclerotic effect of the drugs. In this overview, we will present the complete process of the development of novel non-pharmaceutical products and report the results obtained in the conducted pre-clinical and clinical studies of these medications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Blood Serum Atherogenicity: Cellular Test for the Development of Anti- Atherosclerotic Therapy

Myasoedova

Ivashinnikova²,

Собенин

et al. 2017

CPD

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“…In one study, when evaluating smoking in the sub-population of people with peripheral arterial disease, it was found that approximately 26% smoke, and as many as 79% have a smoking history, either current or former (Dunkley, et al, 2007). Smoking is a top modifiable risk factor contributing to PAD, second only to diabetes (Alexopoulos, Vlachopoulos, & Stefanadis, 2010;Conen et al, 2011;Hennrikus et al, 2010;Federman and Kravetz, 2007;Katsiki, Papadopoulou, Fachantidou, & Mikhailidis, 2013;Lu, Mackay, & Pell, 2014;Moyer, 2013;Muir, 2009;Paraskevas, Papas, Pavlidis, Bessias, & Andrikopoulos, 2008;Simmons, Steffen, & Sanders, 2012;Sontheimer, 2006;Steffen, Duprez, Boucher, Ershow, & Hirch, 2008;Verma, Prasad, Elkadi, & Chi, 2011;Watson, Watson, & Pater, 2006;Wiley, Kumar, & Vacek, 2012). Increased pack years of smoking increases the risks of developing PAD, and increases the morbidity and mortality of the diagnosis, demonstrating a dose-dependent relationship between the two (Au, Golledge, Walker, Haigh, & Nelson, 2013;Hankey, Norman, & Eikelboom, 2006;Katsiki et al, 2013;Lee et al, 2011;Paraskevas et al, 2008;Watson, Watson, & Pater, 2006).…”

Section: Problem Statementsmentioning

confidence: 99%

“…Peripheral arterial disease of the extremities is diagnosed clinically by the ankle brachial index (ABI), a diagnostic tool which is assessed with standard protocols and calculates the index using a ratio of the highest systolic blood pressure in the arm compared with the highest systolic pressure in the legs. Peripheral arterial disease is defined by an ABI of 0.90 or less, and the ABI is associated with high sensitivity and specificity (Aboyans et al, 2011;Aiman et al, 2014;Aronow, 2007a;Aronow, 2007b;Aronow, 2010;Federman and Kravetz, 2007;Hankey et al, 2006;Hennion & Siano, 2013;Hennrikus et al, 2010;Hiatt & Krantz, 2006;Kroger et al, 2009;Lee et al, 2011;Madia, 2012;Moyer, 2013;Simmons, Steffen, & Sanders, 2012;Sontheimer, 2006;Steffen et al, 2008;Verma et al, 2011;Watson, Watson, & Pater, 2006;Wiley, Kumar, & Vacek, 2012). Low ABIs have been proven to be an independent risk factor of cardiovascular risk and as a predictor for future cardiac events such as coronary artery disease, stroke, and death Hankey et al, 2006;Steffen et al, 2008).…”

Section: Peripheral Arterial Disease Smoking and Smoking Cessationmentioning

confidence: 99%

Incorporating Disease-Oriented Smoking Cessation Education into the Care of Smokers with Peripheral Arterial Disease

Newsom¹

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Background and Significance Smoking is a major health issue in the United States, with nearly 18% of the population being reported as active smokers. Smoking is a contributing factor to many chronic diseases, such as peripheral arterial disease, and is a public health concern significant to nursing practice. Problem Statement Despite evidence of the detriments of smoking, many patients with peripheral arterial disease receive minimal smoking cessation education, and cessation aides are rarely utilized. Project Design A disease-oriented smoking cessation education intervention was developed modeling the 5 A's of smoking cessation and utilized for active smokers with peripheral arterial disease. This pilot study evaluated the feasibility of implementing the practice change in a specialty practice. Evaluation Plan Patients' number of cigarettes smoked daily, readiness to change, and attitudes towards the intervention were evaluated. Percent of eligible people who obtained the intervention were tracked to evaluate process. The cost-effectiveness of the intervention was a major consideration. Results The intervention reached 69% of those who met inclusion criteria. Most participants found the intervention helpful. Participants reduced smoking by 60.8% and moved forward toward smoking cessation by 1.0 stage of change. A cost/benefit analysis revealed the intervention was cost-effective. Recommendations This cost-effective practice change should be implemented across a variety of practice settings as part of comprehensive healthcare approach to smoking cessation.

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“…Simmons, Steffen, & Sanders, 2012). Intermittent claudication is the mildest symptomatic manifestation of PAD (Lauret et al, 2012).…”

Section: Physical Assessmentmentioning

confidence: 99%

Can a nurse-led intervention program for people with peripheral arterial disease lead to sustained improvement in functional capacity and quality of life?

McLennan¹

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Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis which causes significant morbidity and mortality affecting between 14% and 29% of individuals >70 years of age . Multiple studies have demonstrated an improvement in walking distance in people suffering from symptomatic PAD through exercise therapy. While most studies have examined the results of exercise and risk factor modification programs over a short-term this study sought to identify not only whether a nurse-led intervention program can improve functional capacity and quality of life, but if improvements could be sustained over a longer follow-up term. After a mean follow up time of 52 months, the NLIP group had sustained a 14% mortality rate. This is in keeping with the 5-year predicted mortality found amongst PAD sufferers. 3The results from this study suggest that a nurse-led intervention program for people with PAD can have sustained improvement in pain free walking distance and emotional well-being. Further research is required to identify whether earlier intervention may lead to a reduction in mortality rates in PAD population.4

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Medical therapy for peripheral arterial disease

Abstract: PAD is associated with increased risk of cardiovascular morbidity and mortality. Medical therapy is targeted toward systemic atherosclerosis and risk factor modification. Exercise therapy is the most studied and validated therapy for symptomatic peripheral arterial disease.

Cited by 19 publications

References 66 publications

Blood Serum Atherogenicity: Cellular Test for the Development of Anti- Atherosclerotic Therapy

Blood Serum Atherogenicity: Cellular Test for the Development of Anti- Atherosclerotic Therapy

Incorporating Disease-Oriented Smoking Cessation Education into the Care of Smokers with Peripheral Arterial Disease

Can a nurse-led intervention program for people with peripheral arterial disease lead to sustained improvement in functional capacity and quality of life?

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