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PAD AND Calcification AND Blood pressure

Timothy W Churchill, Suraj P Rasania, Hashmi Rafeek, Claire K Mulvey, Karen Terembula, Victor Ferrari, Saurabh Jha, Scott M Lilly, Luis H Eraso, Muredach P Reilly, Atif N Qasim
BACKGROUND: Calcification of the thoracic aorta is a risk factor for cardiovascular disease and peripheral arterial disease but has not been well studied in diabetics. In addition, many studies consider aortic calcium as a single anatomic entity, whereas calcification of the ascending and descending portions of the thoracic aorta may represent separate phenotypes. We sought to characterize the prevalence of ascending and descending aortic calcium among diabetics and to assess their associations with cardiovascular risk factors, coronary artery calcium, and peripheral arterial disease...
September 2015: Journal of Cardiovascular Computed Tomography
R M Stoekenbroek, D T Ubbink, J A Reekers, M J W Koelemay
OBJECTIVE/BACKGROUND: Arterial calcification may render the ankle-brachial index (ABI) unreliable in diabetic patients. Although guidelines recommend the toe-brachial index (TBI) for patients with falsely elevated ABI arbitrarily defined as an ABI > 1.4, arterial calcification is also common among diabetic patients with an ABI ≤ 1.4. This could result in a "falsely normalized" ABI and under-diagnosis of peripheral arterial disease (PAD). We investigated whether diabetes invalidates the ABI as opposed to the TBI, and if the TBI may therefore be more suitable for detecting PAD in diabetic patients...
February 2015: European Journal of Vascular and Endovascular Surgery
Esther Chicharro-Luna, Miguel Angel Gracia-Vesga, Domingo Orozco-Beltrán
The objective is to determine the presence of peripheral arterial disease (PAD) and the factors associated in elderly patients, analyzing variables such as sex, age, smoking, diabetes, hypertension, dyslipidemia, and cardiovascular problems. The investigation was conducted in 257 patients by assessing their ankle-brachial index (ABI). To do this, WatchBP Office, a specific automatic blood pressure measurement device for assessing ABI, was used. A greater presence of arterial occlusion (ABI < 0.90) was observed in males, and a greater predominance of calcification (ABI > 1...
May 2014: Revista de Enfermería
C E Aubert, P Cluzel, S Kemel, P-L Michel, F Lajat-Kiss, M Dadon, A Hartemann, O Bourron
AIMS: Pulse palpation and ankle brachial index are recommended to screen for peripheral arterial occlusive disease in people with diabetes. However, vascular calcification can be associated with false negative tests (arteriopathy present despite normal screening tests). We therefore studied the impact of peripheral vascular calcification on the performance of these tests. METHODS: This cross-sectional study included 200 people with diabetes at high risk of cardiovascular disease...
February 2014: Diabetic Medicine: a Journal of the British Diabetic Association
Anna Spångéus, Magnus Wijkman, Torbjörn Lindström, Jan E Engvall, Carl Johan Östgren, Fredrik H Nystrom, Toste Länne
AIM: To explore risk factors for peripheral arterial disease (PAD) as well as the association between toe blood pressure and subclinical and clinical central vascular disease in patients with type 2 diabetes. METHOD: Toe brachial index (TBI) was cross-sectionally analyzed in 742 middle-aged (54-66 years) patients with type 2 diabetes as well as non-diabetic controls and related to other vascular measures (e.g. carotid intima media thickness (IMT), presence of carotid plaque, central arterial stiffness and left ventricular mass index) and previous cardiovascular events...
May 2013: Diabetes Research and Clinical Practice
Bobby W Tullos, Jung Hye Sung, Jae Eun Lee, Michael H Criqui, Marc E Mitchell, Herman A Taylor
To examine the associations of peripheral atherosclerosis, assessed by the ABI at baseline with the extent of AAC and with CAC measured by MDCT at follow-up examination in the Jackson Heart Study cohort. Four categories of ABI: <0.90, 0.90-0.99, 1.00-1.39; >1.40. Presence of CAC/AAC was defined as scoring above the 75th percentile among participants with non-zero CT calcium scores. We conducted multivariable log-binomial models for this analysis examining the relationship between ABI and the presence of CAC or AAC using normal ABI (1...
April 2013: International Journal of Cardiovascular Imaging
(no author information available yet)
BACKGROUND: HASH(0x420cfa0) OBJECTIVE: In January 2010, the Medical Advisory Secretariat received an application from University Health Network to provide an evidentiary platform on stenting as a treatment management for peripheral artery disease. The purpose of this health technology assessment is to examine the effectiveness of primary stenting as a treatment management for peripheral artery disease of the lower extremities. CLINICAL NEED: CONDITION AND TARGET POPULATION Peripheral artery disease (PAD) is a progressive disease occurring as a result of plaque accumulation (atherosclerosis) in the arterial system that carries blood to the extremities (arms and legs) as well as vital organs...
2010: Ontario Health Technology Assessment Series
Mitsuyoshi Takahara, Hideaki Kaneto, Osamu Iida, Naoto Katakami, Taka-Aki Matsuoka, Masahiko Ikeda, Iichiro Shimomura
OBJECTIVE: To investigate whether diabetes and regular hemodialysis are associated with false elevation of ankle systolic blood pressure and ankle-brachial systolic pressure index (ABI) because of their arterial calcification in patients with critical limb ischemia (CLI). RESEARCH DESIGN AND METHODS: We recruited 269 Japanese patients who underwent endovascular therapy for CLI. Ankle systolic blood pressure and ABI were assessed before endovascular therapy. Arterial stenosis and calcification were evaluated angiographically...
October 2012: Diabetes Care
Christopher Scanlon, Kris Park, David Mapletoft, Lindy Begg, Joshua Burns
BACKGROUND: A reliable tool to measure arterial flow to the feet in people with diabetes is required given that they are particularly prone to peripheral arterial disease. Traditionally, the ankle brachial index (ABI) has been used to measure arterial circulation, but its application is limited due to calcification of larger arteries. More recently, toe pressure and the toe brachial index (TBI) has been suggested as superior to ABI measurements because they assess smaller digital arteries less prone to arterial calcification...
2012: Journal of Foot and Ankle Research
Maryam Kavousi, Suzette Elias-Smale, Joost H W Rutten, Maarten J G Leening, Rozemarijn Vliegenthart, Germaine C Verwoert, Gabriel P Krestin, Matthijs Oudkerk, Moniek P M de Maat, Frank W G Leebeek, Francesco U S Mattace-Raso, Jan Lindemans, Albert Hofman, Ewout W Steyerberg, Aad van der Lugt, Anton H van den Meiracker, Jacqueline C M Witteman
BACKGROUND: Whether newer risk markers for coronary heart disease (CHD) improve CHD risk prediction remains unclear. OBJECTIVE: To assess whether newer risk markers for CHD risk prediction and stratification improve Framingham risk score (FRS) predictions. DESIGN: Prospective population-based study. SETTING: The Rotterdam Study, Rotterdam, the Netherlands. PARTICIPANTS: 5933 asymptomatic, community-dwelling participants (mean age, 69...
March 20, 2012: Annals of Internal Medicine
P Rozas Moreno, R Reyes García, A García-Martín, M Varsavsky, J A García-Salcedo, M Muñoz-Torres
BACKGROUND: The role of osteoprotegerin (OPG) as a marker of cardiovascular disease (CVD) in Type 2 diabetes (T2DM) is not well established. Moreover, the relationship between OPG, osteoporosis, and vertebral fractures in T2DM remains to be elucidated. AIM: To determine the role of serum OPG in the prediction of CVD and bone disease in T2DM males. SUBJECTS AND METHODS: Cross-sectional study with 68 males, 43 with T2DM and 25 subjects without diabetes...
January 2013: Journal of Endocrinological Investigation
Faisal A Arain, Zi Ye, Kent R Bailey, Qian Chen, Guanghui Liu, Cynthia L Leibson, Iftikhar J Kullo
OBJECTIVES: This study sought to compare survival of patients with poorly compressible arteries (PCA) to those with a normal ankle-brachial index (ABI) and those with peripheral arterial disease (PAD). BACKGROUND: Limited data are available regarding survival in patients with PCA identified in the clinical setting by noninvasive lower extremity arterial evaluation. METHODS: We conducted a historical cohort study of consecutive patients who underwent outpatient, noninvasive lower extremity arterial evaluation at the Mayo Clinic, Rochester, Minnesota, from January 1998 through December 2007, and who were followed for a mean duration of 5...
January 24, 2012: Journal of the American College of Cardiology
M Zagura, M Serg, P Kampus, M Zilmer, J Eha, E Unt, J Lieberg, J R Cockcroft, J Kals
OBJECTIVE: Arterial stiffness is a significant determinant of cardiovascular risk and is related to vascular calcification. Vitamin D may regulate arterial calcification and has been associated with cardiovascular survival benefits. However, data about the relationship between arterial stiffness, aortic calcification and vitamin D levels in patients with peripheral arterial disease (PAD) and in healthy subjects are limited. We examined the potential association between aortic calcification, arterial stiffness and vitamin D levels in patients with symptomatic PAD and in healthy individuals...
November 2011: European Journal of Vascular and Endovascular Surgery
Anand Prasad, Christina L Wassel, Nicole E Jensky, Matthew A Allison
OBJECTIVES: The purpose of the present study was to determine the prevalence and risk factor associations for subclavian artery calcification. BACKGROUND: Arterial calcification is a marker of atherosclerosis, and its presence portends an adverse prognostic risk. The prevalence and associated risk factors for aortic arch, carotid, renal, and coronary calcification have been well described. Fewer data are available for subclavian artery calcification. METHODS: Electron-beam computed tomography was used to evaluate the extent of vascular calcification in multiple arterial beds in 1387 consecutive individuals who presented for preventive medicine services at a university-affiliated disease prevention center...
November 2011: Journal of Vascular Surgery
Teresa Adragao, Ana Pires, Patrícia Branco, Rui Castro, Ana Oliveira, Cristina Nogueira, Joaquim Bordalo, José Dias Curto, Mateus Martins Prata
BACKGROUND: The ankle-brachial index (ABI) is a noninvasive method to evaluate peripheral artery disease (PAD). ABI <0.9 diagnoses PAD; ABI >1.3 is a false negative caused by noncompressible arteries. The aim of this study is to evaluate the association between ABI with vascular calcifications (VC) and with mortality, in haemodialysis (HD) patients. METHODS: We studied 219 HD patients (60% male; 20% diabetic). At baseline, ABI was evaluated by a Doppler device...
January 2012: Nephrology, Dialysis, Transplantation
Dimitri Aerden, Dany Massaad, Karl von Kemp, Franciscus van Tussenbroek, Erik Debing, Bart Keymeulen, Pierre Van den Brande
BACKGROUND: The ankle--brachial index (ABI) is a simple, noninvasive, widely used test that detects peripheral arterial disease (PAD). In patients with diabetes, the ABI is notoriously unreliable and this is usually attributed to medial calcinosis, which stiffens the arteries and renders them poorly compressible. However, the distribution of atherosclerotic lesions in those with diabetes is different as well: lesions predominantly reside in below-the-knee (BTK) arteries. To what extent this contributes to the unreliability of the ABI is unknown...
August 2011: Annals of Vascular Surgery
Hayan Jouni, Richard J Rodeheffer, Iftikhar J Kullo
OBJECTIVE: To determine whether serum levels of N-terminal (NT) pro-B-type natriuretic peptide (pro-BNP) are higher in patients with poorly compressible arteries (PCA) than in patients with peripheral artery disease (PAD) and control subjects without PCA or PAD. METHODS AND RESULTS: Medial arterial calcification in the lower extremities results in PCA and may be associated with increased arterial stiffness and hemodynamic/myocardial stress. PCA was defined as having an ankle-brachial index >1...
January 2011: Arteriosclerosis, Thrombosis, and Vascular Biology
T Willenberg, N Diehm, M Zwahlen, C Kalka, D-D Do, S Gretener, J Ortmann, I Baumgartner
OBJECTIVE: Ectopic calcification and mediacalcinosis can be promoted by corticosteroid use. Aim of the present investigation is to describe macrovascular disease features in patients with long-term corticosteroid therapy and symptomatic lower limb peripheral arterial occlusive disease (PAD). METHODS: A consecutive series of 2783 patients undergoing clinical and angiographic work-up of PAD were screened for long-term (>5 years) corticosteroid use (group A). Comparison was performed to a randomly selected age-, sex- and risk factor-matched PAD control cohort from the same series without corticosteroid use (group B)...
April 2010: European Journal of Vascular and Endovascular Surgery
Danny Chan, Matthew E Anderson, Bart L Dolmatch
Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis that commonly affects the lower extremities. The diagnosis of PAD and the subsequent treatment decisions rely on clinical exam and non-invasive imaging. The imaging modalities that aid in both diagnosis and treatment are the non-invasive vascular laboratory, computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Each modality has its own advantages and limitations. Non-invasive vascular laboratory testing can be used as a good screening tool for PAD and is often used in conjunction with an additional imaging modality if necessary...
March 2010: Techniques in Vascular and Interventional Radiology
Manuel Carnero-Alcázar, Fernando Reguillo-Lacruz, Ali Alswies, Enrique Villagrán-Medinilla, Luis Carlos Maroto-Castellanos, Joséenrique Rodríguez-Hernández
Population over 80 years who require surgery for degenerative aortic stenosis has largely increased in the past decades. We have compared short- and mid-term results for conventional aortic valve replacement (AVR) for calcific-degenerative aortic stenosis in older and younger than 80 years operated at our institution between April 2004 and December 2008. Predictors of mortality and major adverse cardio and cerebrovascular events (MACCEs) on the postoperative and follow-up period were determined through multivariable analysis...
April 2010: Interactive Cardiovascular and Thoracic Surgery
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