Presence of Peripheral Artery Disease Is Associated With Increased Risk of Heart Failure Events: Insights From EMPEROR-Pooled

Verma, Subodh; Dhingra, Nitish K; Bonaca, Marc P.; Butler, Javed; Anker, Stefan D.; Ferreira, João Pedro; Filippatos, Gerasimos; Januzzi, James L.; Lam, Carolyn S.P.; Sattar, Naveed; Iwata, Tomoko; Nordaby, Matias; Brueckmann, Martina; Pocock, Stuart J.; Packer, Milton

doi:10.1161/atvbaha.123.319156

Cited by 4 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When including SGLT2is as first-line treatment or in addition to metformin, it is important to ensure that the patient is treated with the maximum tolerated dose of a single RAA system inhibitor (ACEi or ARB) [ 150 ]. Glomerular filtration rate (eGFR) should be >20 mL/min/1.73 m 2 for initiation of empagliflozin (EMPA-REG OUTCOME trial, EMPEROR-POOLED trial), >25 mL/min/1.73 m 2 for dapagliflozin (DAPA-CKD trial, DECLARE-TIMI 58 trial), and >30 mL/min/1.73 m 2 for canagliflozin (CREDENCE trial) [ 151 , 152 , 153 , 154 , 155 , 156 , 157 ]. The action of an SGLT2i is to reduce circulating blood preload and afterload, decrease glomerular filtration pressure, and block glucose reuptake in the proximal tubules of nephrons.…”

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

“…A mild decrease in eGFR of 3–4 mL/min/1.73 m 2 is generally observed after the first doses of an SGLT2i; however, if the decrease in eGFR exceeds 30% of the baseline value, the drug should be discontinued [ 150 ]. An increased urinary glucose excretion may result in an increase in urinary tract infections, including bacterial and fungal [ 151 , 152 , 153 , 154 , 155 , 156 , 157 ]. However, a meta-analysis of the RCTs showed similar incidence of urinary tract infections in patients receiving empagliflozin (RR 0.99, 95% CI 0.91–1.08) and canagliflozin (RR 1.10, 95% CI 0.90–1.33) as compared to placebo [ 151 , 152 ].…”

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

“…The results for elderly patients with non-coronary artery atherosclerosis are highly controversial. Among those with a history of cardiovascular disease and hypertension, a meta-analysis of patients over 65 years of age, including 653 participants who received dapagliflozin and 535 receiving placebo, found no difference in cardiovascular event rates between groups (26 vs. 23 events, HR, 0.916; 95% CI, 0.512–1.640) [ 153 ]. However, the groups consisted of patients above 80 years of age only in a small part of the study.…”

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

“…However, when adding a new antidiabetic agent, we should also consider the risk of volume depletion. In patients treated with SGLT2is, volume depletion, a risk factor for acute limb ischemia, could be particularly dangerous in patients aged ≥ 75 y. compared to younger age categories [ 153 , 156 , 160 , 161 , 171 ].…”

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

See 3 more Smart Citations

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

Piechocki,

Przewłocki,

Pieniążek

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Aging is a key risk factor for atherosclerosis progression that is associated with increased incidence of ischemic events in supplied organs, including stroke, coronary events, limb ischemia, or renal failure. Cardiovascular disease is the leading cause of death and major disability in adults ≥ 75 years of age. Atherosclerotic occlusive disease affects everyday activity, quality of life, and it is associated with reduced life expectancy. As most multicenter randomized trials exclude elderly and very elderly patients, particularly those with severe comorbidities, physical or cognitive dysfunctions, frailty, or residence in a nursing home, there is insufficient data on the management of older patients presenting with atherosclerotic lesions outside coronary territory. This results in serious critical gaps in knowledge and a lack of guidance on the appropriate medical treatment. In addition, due to a variety of severe comorbidities in the elderly, the average daily number of pills taken by octogenarians exceeds nine. Polypharmacy frequently results in drug therapy problems related to interactions, drug toxicity, falls with injury, delirium, and non-adherence. Therefore, we have attempted to gather data on the medical treatment in patients with extra-cardiac atherosclerotic lesions indicating where there is some evidence of the management in elderly patients and where there are gaps in evidence-based medicine. Public PubMed databases were searched to review existing evidence on the effectiveness of lipid-lowering, antithrombotic, and new glucose-lowering medications in patients with extra-cardiac atherosclerotic occlusive disease.

show abstract

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

Section: Pharmacotherapy In the Treatment Of Atherosclerosis And Card...mentioning

confidence: 99%

See 2 more Smart Citations

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

Piechocki,

Przewłocki,

Pieniążek

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…Prevalence of PAD increases considerably with age contributing to 1% of the total global deaths due to disease 1,3 . PAD strongly correlates with occurrence of cardiovascular events thus contributing to an enormous economic burden in both developed and developing nations 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Paired transcriptomic analyses of atheromatous and control vessels reveal novel autophagy and immunoregulatory genes in peripheral artery disease

Machiraju,

Srinivas,

Kannan

et al. 2024

Preprint

View full text Add to dashboard Cite

BackgroundPeripheral artery disease (PAD), a significant health burden worldwide, affects lower extremities due to atherosclerotic changes in the peripheral vessels. Although mechanisms of PAD have been studied, the molecular milieu of the plaques localized within peripheral arteries in patients are not well understood. Thus, to identify PAD lesion specific gene expression profiles precluding genetic, environmental and dietary biases, we studied the transcriptomic profile of plaque tissues normalized to non-plaque tissues from the same donors.MethodsTranscriptomic analysis of 9 paired samples of PAD patients from south Indian population was performed with institutional ethics approval and written consent. Plaque tissues were histologically confirmed. Expression of a select target gene set was done by qPCR from the same tissues. Bioinformatic and network analyses were performed using various statistical tools.ResultsA total of 296 upregulated, 274 downregulated genes and 186 non-coding RNAs were identified. STAG1, SPCC3, FOXQ1 and E2F3 were key downregulated genes and CD93 was top upregulated gene. Autophagosome assembly, cellular response to UV, cytoskeletal organization, TCR signaling and phosphatase activity were key dysregulated pathways identified in the study. Telomerase regulation and autophagy were identified as novel interacting pathways using network analysis. Plaque tissue was predominantly composed of immune cells and dedifferentiated cell populations indicated by cell specific marker imputed gene expression analysis.ConclusionThe current study identifies novel genes, non-coding RNAs, associated regulatory pathways and cell composition of the plaque tissue in PAD patients. The autophagy and immunoregulatory genes may drive novel mechanisms resulting in atheroma. These novel interacting networks and genes have the potential for PAD specific therapeutic applications.

show abstract

Epidemiology and Burden of Peripheral Artery Disease in People With Type 2 Diabetes: A Systematic Literature Review

Verma,

Leiter,

Mangla

et al. 2024

Diabetes Ther

View full text Add to dashboard Cite

Type 2 diabetes (T2D) and lower-extremity peripheral artery disease (PAD) are growing global health problems associated with considerable cardiovascular (CV) and limb-related morbidity and mortality, poor quality of life and high healthcare resource use and costs. Diabetes is a well-known risk factor for PAD, and the occurrence of PAD in people with T2D further increases the risk of long-term complications. As the available evidence is primarily focused on the overall PAD population, we undertook a systematic review to describe the burden of comorbid PAD in people with T2D. The MEDLINE, Embase and Cochrane Library databases were searched for studies including people with T2D and comorbid PAD published from 2012 to November 2021, with no restriction on PAD definition, study design or country. Hand searching of conference proceedings, reference lists of included publications and relevant identified reviews and global burden of disease reports complemented the searches. We identified 86 eligible studies, mostly observational and conducted in Asia and Europe, presenting data on the epidemiology ( n = 62) and on the clinical ( n = 29), humanistic ( n = 12) and economic burden ( n = 12) of PAD in people with T2D. The most common definition of PAD relied on ankle-brachial index values ≤ 0.9 (alone or with other parameters). Incidence and prevalence varied substantially across studies; nonetheless, four large multinational randomised controlled trials found that 12.5%–22% of people with T2D had comorbid PAD. The presence of PAD in people with T2D was a major cause of lower-limb and CV complications and of all-cause and CV mortality. Overall, PAD was associated with poor quality of life, and with substantial healthcare resource use and costs. To our knowledge, this systematic review provides the most comprehensive overview of the evidence on the burden of PAD in people with T2D to date. In this population, there is an urgent unmet need for disease-modifying agents to improve outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-024-01606-6.

show abstract

Presence of Peripheral Artery Disease Is Associated With Increased Risk of Heart Failure Events: Insights From EMPEROR-Pooled

Cited by 4 publications

References 6 publications

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review PART II—Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary Territory

Paired transcriptomic analyses of atheromatous and control vessels reveal novel autophagy and immunoregulatory genes in peripheral artery disease

Epidemiology and Burden of Peripheral Artery Disease in People With Type 2 Diabetes: A Systematic Literature Review

Contact Info

Product

Resources

About