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peripherical artery disease

Changhwan Seo, Seonghun Kim, Misol Lee, Min-Uk Cha, Hyoungnae Kim, Seohyun Park, Hae-Ryong Yun, Jong Hyun Jhee, Youn Kyung Kee, Seung Hyeok Han, Tae-Hyun Yoo, Shin-Wook Kang, Jung Tak Park
OBJECTIVE: Patients with diabetic nephropathy (DMN) have an increased risk of cardiovascular disease (CVD). However, strategies to reduce this risk are limited. Thyroid hormone replacement therapy (THRT) in patients with hypothyroidism has been shown to reduce several surrogate markers of CVD. Therefore, we performed a study to determine if THRT would reduce CVD risk in patients with subclinical hypothyroidism (SCH) and DMN. METHODS: This was a retrospective, nonrandomized study of patients with type 2 diabetes, DMN, and SCH...
March 2018: Endocrine Practice
John A Phillips, Anna Falls, Raghu Kolluri, Aaron Whipp, Christy Collins, Samer Mohir-Sadaai, Blake Reid, Nirav Patil, Maurice Alston, Melissa Troyan, Gary M Ansel
PURPOSE: To evaluate the 1- and 2-year patency and reintervention rates with the Zilver PTX drug-eluting stent (DES) in long complex femoropopliteal disease. METHODS: A retrospective review was conducted of 89 consecutive patients (mean age 68.7±9.8 years; 86 men) with femoropopliteal occlusive disease (Rutherford category 2-6) treated with the Zilver PTX between December 2012 and December 2013. Mean lesion length for the entire cohort was 24.2±11.3 cm (median 24...
March 1, 2018: Journal of Endovascular Therapy
Wengao Jiang, Qiang Tang, Lei Zhang, Yinxue Chao, Bing Hong
OBJECTIVE: Recent studies have indicated the implication of C1q tumour necrosis factor-related protein 9 in vascular pathology of atherosclerosis. This study first investigated the association of C1q tumour necrosis factor-related protein 9 and the severity of lower extremity peripheral arterial disease in type 2 diabetes mellitus patients. METHODS: A total of 200 patients with type 2 diabetes mellitus had ankle-brachial index examined in this cross-sectional study, 60 patients with ankle-brachial index of ⩽0...
March 1, 2018: Diabetes & Vascular Disease Research
Ken Sasaki, Yasuto Uchikado, Itaru Omoto, Masahiko Amatatsu, Koichi Megumi, Hiroshi Okumura, Kosei Maemura, Shoji Natsugoe
Standard treatment strategies have not yet been established for primary malignant melanoma of the esophagus (PMME), and far much less for recurrent disease. There are no reports of anti-programmed death-1 antibody treatment of recurrent PMME. A 60-year-old Japanese man was diagnosed with a primary malignant melanoma in the lower esophagus. The patient underwent mediastinoscope-assisted subtotal esophagectomy, and two nodal involvements were detected in the lymph nodes (LN)s along the left gastric artery. Paclitaxel and oral fluoropyrimidine were administered for 2 months as adjuvant treatment based on results of a histoculture drug response assay...
April 2018: Molecular and Clinical Oncology
Anna Maria Fratta Pasini, Chiara Stranieri, Anna Maria Rigoni, Sergio De Marchi, Denise Peserico, Chiara Mozzini, Luciano Cominacini, Ulisse Garbin
AIM: Ischemia-reperfusion (I-R) produces reactive oxygen species (ROS) that damage cells and favour cytotoxicity and apoptosis in peripheral artery disease (PAD) patients. Since brief episodes of I-R (ischemic conditioning) protect cells against ischemic harms, we evaluated whether a short-course of supervised treadmill training, characterized by repeated episodes of I-R, makes peripheral blood mononuclear cells (PBMCs) from PAD patients with intermittent claudication more resistant to I-R injuries by reducing oxidative stress and by inducing an adaptative response of unfolded protein response (UPR) and nuclear factor-E2-related factor (Nrf2) pathway expression...
March 13, 2018: Journal of Atherosclerosis and Thrombosis
Sonia S Anand, Francois Caron, John W Eikelboom, Jackie Bosch, Leanne Dyal, Victor Aboyans, Maria Teresa Abola, Kelley R H Branch, Katalin Keltai, Deepak L Bhatt, Peter Verhamme, Keith A A Fox, Nancy Cook-Bruns, Vivian Lanius, Stuart J Connolly, Salim Yusuf
BACKGROUND: Patients with lower extremity peripheral artery disease (PAD) are at increased risk of major adverse cardiovascular events (MACE) and major adverse limb events (MALE). There is limited information on the prognosis of patients who suffer MALE. OBJECTIVES: Among participants with lower extremity PAD, we investigated: 1) if hospitalizations, MACE, amputations, and deaths are higher after first episode of MALE compared with PAD patients who do not experience MALE and 2) the impact of treatment with low dose rivaroxaban and aspirin compared to aspirin alone on the incidence of MALE, peripheral vascular interventions, and all peripheral vascular outcomes over a median follow-up of 21 months...
March 7, 2018: Journal of the American College of Cardiology
Zhi-Chun Gu, Yi-Jing Zhang, Mang-Mang Pan, Chi Zhang, Xiao-Yan Liu, An-Hua Wei, Ying-Jie Su
BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive disease and ultimately leads to right heart failure. Endothelin receptor antagonists (ERAs) have been demonstrated to significantly improve prognosis in PAH. However, ERAs-induced side effects can result in poor patient tolerance. Thus, we aim to evaluate current safety evidence of ERAs in PAH. METHODS: An electronic search will be performed for randomized controlled trials (RCTs) that reported the interested safety data (abnormal liver function, peripheral edema, and anemia) of ERAs in PAH...
March 2018: Medicine (Baltimore)
Pasquale Pignatelli, Danilo Menichelli, Daniele Pastori, Francesco Violi
The role of oxidative stress in the onset and progression of atherosclerosis and its impact on the development of cardiovascular events has been widely described. Thus, an increased oxidative stress has been described in several atherosclerotic risk factors, such as hypertension, dyslipidaemia, peripheral artery disease, metabolic syndrome, diabetes and obesity. Among others, specific oxidative pathways involving both pro-oxidant and antioxidant enzymes seem to play a major role in the production of reactive oxidant species (ROS), such as NADPH oxidase, myeloperoxidase, superoxide dismutase, glutathione peroxidase...
March 14, 2018: Kardiologia Polska
Małgorzata Pupek, Dorota Krzyżanowska-Gołąb, Daniel Kotschy, Wojciech Witkiewicz, Wiesława Kwiatkowska, Maria Kotschy, Iwona Kątnik-Prastowska
Fibronectin (FN) may be involved in time- and stage-dependent and inter-related controlled processes of inflammation, coagulation, and wound healing accompanying peripheral arterial disease (PAD). In the present study, FN and FN-containing extra-domain A (EDA-FN), macromolecular FN-fibrin complexes, and FN monomer were analysed in the plasma of 142 PAD patients, including 37 patients with restenosis, for 37 months after revascularisation. FN concentration increased significantly in the plasma of PAD patients within 7 to 12 months after revascularisation, whereas the high concentration of EDA-FN was maintained up to 24 months, significantly higher in the group 7 to 12 months after revascularisation with recurrence of stenosis and lower in the PAD groups 1 to 3 months and 4 to 6 months after revascularisation with comorbid diabetes and ulceration, respectively...
March 13, 2018: International Wound Journal
Saroj Neupane, Sushruth Edla, Eesha Maidona, Matthew C Sweet, Susan Szpunar, Thomas Davis, Thomas A LaLonde, Rajendra H Mehta, Howard S Rosman, Hiroshi Yamasaki
OBJECTIVES: To evaluate the association of diabetes mellitus (DM) with clinical and angiographic characteristics and outcomes of patients with popliteal and infrapopliteal peripheral arterial disease (PAD) undergoing peripheral vascular intervention (PVI). BACKGROUND: Clinical features and outcomes in patients with DM and popliteal or infrapopliteal PAD undergoing PVI are not well described. METHODS: Using the data from the laser in popliteal and infrapopliteal stenosis study, we retrospectively examined the association of diabetes with clinical and angiographic characteristics and risk adjusted short- and intermediate term outcomes (all cause death, major adverse events (MAE) [composite of death, ipsilateral major amputation, or repeat revascularization]) in patients with popliteal and infrapopliteal PAD undergoing PVI for critical limb ischemia treated either with laser-assisted balloon angioplasty or balloon angioplasty alone...
March 14, 2018: Catheterization and Cardiovascular Interventions
Wilbert S Aronow, William H Frishman
The 2017 American College of Cardiology/American Heart Association hypertension guidelines diagnose hypertension if systolic blood pressure (SBP) is ≥ 130 mmHg or diastolic blood pressure (DBP) is ≥ 80 mmHg. Increased BP is SBP 120-129 mmHg with DBP < 80 mmHg. Lifestyle measures should be used to treat individuals with increased BP. Lifestyle measures plus BP-lowering drugs should be used for secondary prevention of recurrent cardiovascular events in individuals with clinical cardiovascular disease (coronary heart disease, congestive heart failure, or stroke) and an average SBP ≥ 130 mmHg or an average DBP ≥ 80 mmHg...
March 13, 2018: Drugs
Bin Bai, Jiadela Teliewubai, Yuyan Lu, Shikai Yu, Jing Xiong, Chen Chi, Yiwu Zhou, Hongwei Ji, Ximin Fan, Jacques Blacher, Jue Li, Yi Zhang, Yawei Xu
This study aimed to investigate the discrepancy between pulse wave velocity (PWV) and pulse pressure amplification (PPA) in association with hypertensive target organ damage (TOD) in the elderly. From June 2014 to August 2015, 1599 participants aged >65 years old from communities located in northern Shanghai were recruited. Carotid-femoral pulse wave velocity (cfPWV), peripheral blood pressure (BP), central BP and other TOD indicators, including the ratio of the early ventricular filling velocity (E) to the peak velocity of the tissue Doppler velocity of septal mitral annulus (E/Ea), left ventricular mass index (LVMI), carotid intima-medium thickness (CIMT), estimated glomerular filtration rate (eGFR), and urinary albumin-creatinine ratio (ACR), were determined for each participant...
March 13, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Joshua A Beckman, Meredith S Duncan, Charles W Alcorn, Kaku So-Armah, Adeel A Butt, Matthew B Goetz, Hilary A Tindle, Jason Sico, Russel P Tracy, Amy C Justice, Matthew S Freiberg
Background -The effect of HIV on the development of peripheral artery disease (PAD) remains unclear. We investigated whether HIV infection is associated with an increased risk of PAD after adjustment for traditional atherosclerotic risk factors in a large cohort of HIV infected (HIV+) and demographically similar HIV uninfected veterans. Methods -We studied participants in the Veterans Aging Cohort Study from April 1, 2003 through December 31, 2014. We excluded participants with known prior PAD or prevalent cardiovascular disease (myocardial infarction, stroke, coronary heart disease, and congestive heart failure) and analyzed the effect of HIV status on the risk of incident PAD events after adjusting for demographics, PAD risk factors, substance use, CD4 cell count, HIV-1 RNA, and antiretroviral therapy...
March 13, 2018: Circulation
Matthew C Bunte, Mehdi H Shishehbor
Endovascular therapy (EVT) of symptomatic peripheral artery disease (PAD) offers relief of symptoms and enhanced quality of life. Advancements in technique and technology have increased the feasibility and practicality of EVT, which now represents the preferred mode of revascularization over surgical procedures in many centers across the world. In this review, we consider the future of EVT in context of a rapidly expanding population of patients with symptomatic PAD.
March 10, 2018: Progress in Cardiovascular Diseases
Steven M Dean
In the contemporary era of medical diagnosis via sophisticated radiographic imaging and/or comprehensive serological testing, a focused physical examination remains paramount in recognizing the cutaneous manifestations of chronic vascular disease. Recognition of the unique cutaneous signs of lymphatic and venous hypertension assists in the diagnosis as well as the staging and classification of both lymphedema and chronic venous insufficiency. Awareness of explicit dermatologic vasomotor manifestations aids not only in the identification of acrocyanosis, Raynaud phenomenon, pernio, and erythromelalgia but also mitigates confusion related to their clinical overlap...
March 10, 2018: Progress in Cardiovascular Diseases
Trisha L Roy, Thomas L Forbes, Andrew D Dueck, Graham A Wright
Magnetic resonance imaging (MRI) has advanced significantly in the past decade and provides a safe and non-invasive method of evaluating peripheral artery disease (PAD), with and without using exogenous contrast agents. MRI offers a promising alternative for imaging patients but the complexity of MRI can make it less accessible for physicians to understand or use. This article provides a brief introduction to the technical principles of MRI for physicians who manage PAD patients. We discuss the basic principles of how MRI works and tailor the discussion to how MRI can evaluate anatomic characteristics of peripheral arterial lesions...
March 1, 2018: Vascular Medicine
B P Bergman, D F Mackay, J P Pell
Background: While traumatic limb loss in military personnel is widely known, the threat posed by peripheral arterial disease (PAD) in those who have served is less well recognized. The aim of our study was to examine the risk of PAD in a Scotland-wide cohort of veterans who served between 1960 and 2012. Methods: Retrospective 30-year cohort study of 56 205 veterans born 1945-85, and 172 741 non-veterans, matched for age, sex and area of residence, using Cox proportional hazard models to examine the association between veteran status, birth cohort, length of service and risk of PAD leading to hospitalization or death...
March 9, 2018: Journal of Public Health
Valerie S Marmolejo, Jonathan F Arnold
Heel ulcerations are a significant burden of care in both hospital and long-term care settings. The presence of peripheral arterial disease as a contributing factor to delayed healing is often not recognized, resulting in prolonged healing and high patient morbidity and mortality. Formal vascular evaluation and intervention is often not performed as these patients can have palpable pedal pulses while having localized ischemia of the heel. As routine noninvasive vascular studies can be affected by medial calcinosis and collateralization and do not specifically assess tissue perfusion to the heel, a false sense of security of adequate perfusion for healing can result...
March 1, 2018: Foot & Ankle Specialist
Philippa Howlett, Jane K Cleal, Huihai Wu, Nikunj Shah, Alex Horton, Nick Curzen, Michael Mahmoudi
Objective: MicroRNAs (miRNAs) may serve as potential biomarkers in a variety of pathologies. The aim of this study was to determine whether miRNAs could serve as blood-based markers of isolated coronary artery calcification (CAC) defined as CAC in the absence of an underlying metabolic abnormality. Methods: 24 age-matched and sex-matched patients who had been referred for elective CT coronary calcium score and angiography as part of investigation for cardiac chest pain were recruited...
2018: Open Heart
Jonathan P Rehfuss, Kenneth M DeSart, Jared M Rozowsky, Kerri A O'Malley, Lyle L Moldawer, Henry V Baker, Yaqun Wang, Rongling Wu, Peter R Nelson, Scott A Berceli
BACKGROUND: Despite being the definitive treatment for lower extremity peripheral arterial disease, vein bypass grafts fail in half of all cases. Early repair mechanisms after implantation, governed largely by the immune environment, contribute significantly to long-term outcomes. The current study investigates the early response patterns of circulating monocytes as a determinant of graft outcome. METHODS: In 48 patients undergoing infrainguinal vein bypass grafting, the transcriptomes of circulating monocytes were analyzed preoperatively and at 1, 7, and 28 days post-operation...
March 2018: Circ Genom Precis Med
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