Peripheral arterial disease of lower extremity and global cardiovascular risk
Authors:
Denisa Čelovská; Viera Štvrtinová
Authors‘ workplace:
I. Interná klinika LF UK a UNB, Bratislava
Published in:
AtheroRev 2018; 3(1): 21-28
Category:
Reviews
Overview
Peripheral arterial disease (PAD) of lower extremity is predominantly a manifestation of atherothrombotic process. Effective cardiovascular risk treatment is underestimated in clinical practice despite significantly increased cardio-cerbro-vascular mortality and morbidity in symptomatic and even in asymptomatic PAD patients. There is a high prevalence of asymptomatic PAD patients that can be detected by an ankle-brachial index (ABI). In PAD patients systolic hypertension is commonly associated with a high pulse pressure and non-dipping pattern. Smoking, diabetes mellitus and atherogenic dyslipidemia are significant risk factors for cardiovascular risk stratification in PAD patients. PAD patients have very high CV risk and the goal level of LDL cholesterol is less than 1,8 mmol/l or even lower according to new studies. What cannot be forgotten is modification of life-style especially in reduction of remnant lipoproteins, which play an important role in peripheral circulation.
Key words:
arterial hypertension, cardiovascular risk, diabetes mellitus, dyslipidemia, peripheral arterial disease of lower extremity
Received:
10. 12. 2017
Accepted:
4. 1. 2018
Sources
1. Štvrtinová V, Štvrtina S. Ischemická bolesť pri periférnom artériovom ochorení končatín. S 111–132. In: Štvrtinová V et al. Bolesť končatín. SAP: Bratislava 2012. ISBN 978–80–89607–05–1.
2. Bartelink ML, Björck M, Brodmann M et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2017. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehx095>.
3. Imori Y, Akasaka T, Ochiai T et al. Co-existence of carotid artery disease, renal artery stenosis, and lower extremity peripheral arterial disease in patients with coronary artery disease. Am J Cardiol 2014; 113(1): 30–35. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjcard.2013.09.015>.
4. Norgren L, Hiatt WR, Dormandy et al. [TASC II Working Group]. Inter-Society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg 2007; 33(Suppl 1): 1–75. Dostupné z DOI:
5. Štvrtinová V, Štvrtina S, Wsólová L et al. Prevalence of peripheral arterial disease in the Slovak Republic. CEVJ 2009; 8(1): 32.
6. Murabito JM, Evans JC, Nieto K et al. Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J 2002; 143(6): 961–965.
7. Gavorník P. Všeobecná angiológia. Angiologická propedeutika. Cievne choroby. 2. ed. UK: Bratislava 2001. ISBN 80–223–1608–3.
8. Šefránek V. Pohľad cievneho chirurga na farmakologickú liečbu periférneho artériového ochorenia dolných končatín. Vask Med 2012; 4(3–4): 70–72. Dostupné z WWW: <http://dx.doi.org/http://www.vaskularnamedicina.sk/index.php?page=pdf_view&pdf_id=6171&magazine_id=16>.
9. Egan BM, Li J, Hutchison FN et al. Hypertension in the United States, 1999 to 2012: progress toward Healthy People 2020 goals. Circulation 2014; 130(19): 1692–1699. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.114.010676>.
10. Centers for Disease Control and Prevention. National Diabetes Statistics Report 2014: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: U.S. Department of Health and Human Services; 2014. Dostupné z WWW: <https://www.cdc.gov/diabetes/pdfs/data/2014-report-estimates-of-diabetes-and-its-burden-in-the-united-states.pdf>.
11. Kotseva K, Wood D, De Bacquer D et al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol 2016; 23(6): 636–648. Dostupné z DOI: <http://dx.doi.org/10.1177/2047487315569401>.
12. Vrablík M. Farmakoterapie dyslipidemie. Maxdorf: Praha 2012. ISBN 978–80–7345–299–5.
13. Selrin E, Marinopoulos S, Berkenblit G et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med 2004; 141(6): 421–431.
14. Štvrtinová V, Ambrózy E, Gašpar Ľ. Syndróm diabetickej nohy z pohľadu angiológa. In: Krahulec B, Gašpar Ľ., Štvrtinová V. Manažment pacienta so syndrómom diabetickej nohy. VEDA: Bratislava 2013: 120–140. ISBN 978–80–224–1293–3.
15. Verma S, Mazer CD, Al-Omran M et al. Empagliflozin in Patients with Type 2 Diabetes Mellitus and Peripheral Artery Disease. A Subanalysis of EMPA-REG OUTCOME. Circulation 2018; 137(4): 405–407. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.117.032031>.
16. Baigent C, Keech A, Kearney PM et al. Cholesterol treatment Trialists’ (CTT) Collaborators: Efficacy and safety of cholesterol – lowering treatment: prospective study meta-analysis of data from 90.056 participants in 14 randomized trials of statins. Lancet 2005; 366(9493): 1267–1278. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(05)67394–1>. Erratum in Lancet 2005; 366(9494): 1358. Lancet 2008; 371(9630): 2084.
17. [Heart Protection Study Collaborative Group]. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002; 360(9326): 7–22. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(02)09327–3>.
18. Mohler ER, Hiatt WR, Creager MA. Cholesterol reduction with atorvastatin improves walking distance in patients with peripheral arterial disease. Circulation 2003; 108(12): 1481–1486. Dostupné z DOI: <http://dx.doi.org/10.1161/01.CIR.0000090686.57897.F5>.
19. Murín J, Pernický M, Kiňová S. Nové liečebné prístupy k dyslipidémii. Cardiology Lett 2014; 23(3): 197–206.
20. Kumbhani DJ, Steg PG, Cannon CP et al. Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry. Eur Heart J 2014; 35(41): 2864 -2872. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehu080>.
21. Štvrtinová V, Šefránek V, Murín J et al. Odporúčania pre diagnostiku a liečbu periférneho artériového ochorenia dolných končatín PAO DK. Vask Med 2010; 2(Suppl 2): 3–18. Dostupné z WWW: <http://www.solen.sk/pdf/3475a13d8e301301733ab2a514d1dccc.pdf>.
22. Gašpar Ľ, Komorníková A, Gavorník P et al. Liečba kritickej končatinovej ischémie prostaglandínom E1. Vask Med 2015; 7(2): 86–88. Dostupné z WWW: <http://www.vaskularnamedicina.sk/index.php?page=pdf_view&pdf_id=7801&magazine_id=16>.
23. Nguyen CD, Andersson Ch, Jensen TD et al. Statins treatment and risk of reccurent venous thromboembolism a nationwide cohort study. BMJ Open 2013; 3(11): e 003135. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2013–003135>.
24. Rajamani K, Colman PG, Li LP et al. FIELD study investigators. Effect of fenofibrate on amputation events in people with type 2 diabetes mellitus (FIELD study): a prespecified analysis of a randomized controlled trial. Lancet 2009; 373(9677): 1780–1788. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)60698-X>.
25. Wang T, Elam MB, Forbes WP et al. Reduction of remnant lipoprotein cholesterol concentrations by cilostazol in patients with intermittent claudication. Atherosclerosis 2003; 171(2): 337–342.
26. Cocher S, Scondotto G, Agnelli G et al. Arterial Arm of the Suavis group. Sulodexide in the treatment of intermittent claudication. Results of a randomized, double blind, multicentre, placebo-controlled study. Eur Heart J 2002; 23(13): 1057–1065.
27. Vrablík M. Zítřky lipidy modifikující terapie – jaké budou? Kardiol Rev 2012; 14(3): 172–175.
28. Vrablík M, Češka R. Novinky v oblasti hypolipidemické léčby. Vnitř Lék 2014; 60(11): 949–957.
29. Sabatine MS, Giugliano MP, Keech AC et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med 2017; 376(18): 1713–1722. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1615664>.
30. Cannon ChP, Blazing MA, Giugliano RP et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015; 372(25): 2387–2397. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1410489>.
31. Mills KT, Bundy JD, Kelly TN et al. Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation 2016; 134(6): 441–450. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.115.018912>.
32. Cífková R, Bruthans J, Adámková V et al. Prevalence základních kardiovaskulárních rizikových faktorů v české populaci v letech 2006–2009. Studie Czech post-MONICA. Cor Vasa 2011; 53(4–5): 220–229.
33. Sninčák M, Balažovjech I, Macháčová E et al. Epidemiológia artériovej hypertenzie na Slovensku. Interná med 2006; 6(11 Suppl 3): 3–26.
34. Vidal-Petiot E, Ford I, Greenlaw N et al. Cardiovascular event rates and mortality according to achieved systolic and diastolic blood pressure in patients with stable coronary artery disease: an international cohort study. Lancet 2016; 388(10056): 2142–2152. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(16)31326–5>.
35. Wright JT Jr, Williamson JD, Whelton PK et al. [SPRINT Research Group]. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373(22): 2103–116. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1511939>. Erratum in A Randomized Trial of Intensive versus Standard Blood-Pressure Control. [N Engl J Med. 2017].
36. Whelton PK, Carey RM, Aronow WS et al. Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. J Am Coll Cardiol 2017. pii: S0735–1097(17)41519–1. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2017.11.006>.
37. Cífková R. Aktuální trendy ve farmakoterapii hypertenze. Interní Med 2017; 19(1): 10–15.
38. Yusuf S, Sleight P, Pogue J et al. Heart Outcomes Prevention Evaluation Study Investigators Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342(3):145–153. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM200001203420301>. Erratum in N Engl J Med 2000; 342(18): 1376. N Engl J Med 2000 Mar; 342(10): 748.
39. Fox KM, Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomized, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet 2003; 362(9386):782–788.
40. Yusuf S, Teo KK, Pogue J et al. Telmisartan, ramipril, or both in patients at high risk for vascular Events. N Engl J Med 2008; 358(15):1547–1559. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0801317>.
41. Paravastu SC, Mendonca DA, da Silva A. Betablockers for peripheral arterial disease. Cochrane Database Syst Rev 2008; (4): CD 005508. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD005508.pub2>.
42. Espinola-Klein CH, Weisse G, Jagodzinski A et al. β-Blockers in Patients With Intermittent Claudication and Arterial Hypertension. Results From the Nebivolol or Metoprolol in Arterial Occlusive Disease Trial. Hypertension 2011; 58(2):148–154. Dostupné z DOI: <http://dx.doi.org/10.1161/HYPERTENSIONAHA.110.169169>.
43. Pande RL, Hiatt WR, Zhang P et al. A pooled analysis of the duarability and predictors of treatment response of cilostazol in patients with intermittent claudivation. Vasc Med 2010; 15(3): 181–188. Dostupné z DOI: <http://dx.doi.org/10.1177/1358863X10361545>.
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