Prior peripheral arterial disease and cerebrovascular disease are independent predictors of adverse outcome in patients with acute coronary syndromes: Are we doing enough? Results from the Orbofiban in Patients with Unstable Coronary Syndromes-Thrombolysis In Myocardial Infarction (OPUS-TIMI) 16 study

Cotter, Gad; Cannon, Christopher P.; McCabe, Carolyn H.; Michowitz, Yoav; Kaluski, Edo; Charlesworth, Andrew; Milo, Olga; Bentley, Jane; Blatt, Alex; Krakover, Ricardo; Zimlichman, Reuven; Reisin, Leonardo; Marmor, Alon; Lewis, Basil S.; Vered, Zvi; Caspi, Avi; Braunwald, Eugene

doi:10.1067/mhj.2003.6

Cited by 135 publications

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“…In the OPUS TIMI 16 study, investigators concluded that patients with both acute coronary syndrome and extracardiac vascular disease show an association with more severe CAD and worse outcomes. Those patients have probably received less aggressive treatment, which partially explains the higher occurrence of adverse outcomes 17 . In the Dante Pazzanese risk score, previous stroke was considered a factor for worse prognosis, having been kept in the final model.…”

Section: Discussionmentioning

confidence: 99%

Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST

Santos¹,

Timerman

Baltar

et al. 2009

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST

Santos¹,

Timerman

Baltar

et al. 2009

Arq. Bras. Cardiol.

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“…9 Patients with PAD have worse outcomes after acute ischemic events and hospitalizations for acute coronary syndrome and after percutaneous coronary interventions. 1,10 Current guidelines for secondary prevention and risk reduction therapy in patients with PAD recommend antiplatelet therapy, lipid-lowering therapy with a statin to achieve a goal low-density lipoprotein (LDL; Ͻ100 mg/dL or Ͻ70 mg/dL in high-risk patients), and antihypertensive therapy to achieve a systolic blood pressure Ͻ140 mm Hg (or Ͻ130 mm Hg in diabetics and patients with chronic renal disease). 2,11 Despite these guidelines, cross-sectional studies, registries, and surveys have consistently shown that the use of proven cardioprotective medication for secondary prevention in patients with PAD significantly lags behind treatment for CAD.…”

mentioning

confidence: 99%

Medical Management of Peripheral Arterial Disease

Owens

Conte

2012

Circulation

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P eripheral artery disease (PAD) is estimated to affect 27 million individuals in Europe and North America, and its prevalence is increasing in concert with recent demographic and risk factor trends. 1 The majority of patients with PAD either are asymptomatic or have atypical leg symptoms, with classic claudication in only 10% to 35%; therefore, detection is elusive unless actively sought. 2 Given shared risk factors, it is axiomatic that a high coprevalence of atherosclerosis in other vascular beds exists, including the coronary arteries in PAD patients. However, PAD disproportionately affects the elderly, nonwhites, and women compared with coronary artery disease (CAD) alone. 3,4 The actual coprevalence of CAD in patients with established PAD depends on how closely it is searched for, with clinical history and ECG detecting only 20% to 40% of coexisting disease and cardiac catheterization detecting CAD in as many as 90% of PAD patients. 5,6 Article see p 1345There is a direct relationship between the severity of PAD (eg, as measured by the ankle brachial index) and cardiovascular and overall mortality, regardless of whether the PAD is symptomatic or not. 7,8 In general, men and women with PAD have an Ϸ5-fold greater risk of cardiovascular mortality and a 3-fold greater risk for all-cause mortality even after adjustment for known Framingham risk factors. 9 Patients with PAD have worse outcomes after acute ischemic events and hospitalizations for acute coronary syndrome and after percutaneous coronary interventions. 1,10 Current guidelines for secondary prevention and risk reduction therapy in patients with PAD recommend antiplatelet therapy, lipid-lowering therapy with a statin to achieve a goal low-density lipoprotein (LDL; Ͻ100 mg/dL or Ͻ70 mg/dL in high-risk patients), and antihypertensive therapy to achieve a systolic blood pressure Ͻ140 mm Hg (or Ͻ130 mm Hg in diabetics and patients with chronic renal disease). 2,11 Despite these guidelines, cross-sectional studies, registries, and surveys have consistently shown that the use of proven cardioprotective medication for secondary prevention in patients with PAD significantly lags behind treatment for CAD. 12,13 The reasons behind this gap in treatment aggressiveness for atherosclerosis in the periphery remain unclear. Cross-sectional "snapshots" are limited by a lack of incidence data, an incomplete assessment of medication compliance, and an inability to capture practice trends over time. Importantly, they also fail to provide information on the impact of the incident diagnosis of PAD on subsequent medical management, reflecting the treating physician's awareness and attitudes toward PAD and its treatment. It is here that the report by Subherwal and colleagues 14 of a longitudinal, population-based cohort study conducted in Denmark has given us a valuable insight.The latitude and longitude of Denmark are 56°north and 10[east] east, roughly the same latitude as Scotland, Canada, and Alaska. There are 3.4 physicians per 1000 residents, and health expenditure i...

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“…With type B femoro-popliteal lesions, PTA with additional stenting did not significantly improve the one-year patency rate (27). New stenting procedures and angioplasty techniques are being evaluated and show initially promising results (drugeluting balloon, drug-eluting stents).…”

Section: Invasive Treatmentmentioning

confidence: 99%

Peripheral arterial occlusive disease (PAOD)

Jeanneret-Gris¹

2014

Phlebologie

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Cited by 135 publications

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Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST

Escore de risco Dante Pazzanese para síndrome coronariana aguda sem supradesnivelamento do segmento ST

Medical Management of Peripheral Arterial Disease

Peripheral arterial occlusive disease (PAOD)

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