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Gardner AW, Montgomery PS, Wang M, Liang M, Proctor DN. Maximal calf conductance is associated with 6-minute walk distance in participants with and without peripheral artery disease. Vasc Med 2023; 28:113-121. [PMID: 36847177 DOI: 10.1177/1358863x231155299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION The aims were (a) to compare the maximal calf conductance and 6-minute walk distance of participants with and without peripheral artery disease (PAD) and claudication, (b) to determine whether maximal calf conductance was more strongly associated with 6-minute walk distance in participants with PAD than in the controls, and (c) to determine whether this association was significant in participants with PAD after adjusting for ABI, as well as for demographic, anthropometric, and comorbid variables. METHODS Participants with PAD (n = 633) and without PAD (n = 327) were assessed on maximal calf conductance using venous occlusion plethysmography, and on 6-minute walk distance. Participants were further characterized on ABI, and on demographic, anthropometric, and comorbid variables. RESULTS The PAD group had lower maximal calf conductance than the control group (0.136 ± 0.071 vs 0.201 ± 0.113 mL/100 mL/min/mmHg, p < 0.001). Additionally, the PAD group had a lower 6-minute walk distance (375 ± 98 m vs 480 ± 107 m, p < 0.001). Maximal calf conductance was positively associated with 6-minute walk distance in both groups (p < 0.001) and was more strongly associated in the PAD group (p < 0.001). In adjusted analyses, maximal calf conductance remained positively associated with 6-minute walk distance in the PAD group (p < 0.001) and in the control group (p < 0.001). CONCLUSIONS Participants with PAD and claudication had impaired maximal calf conductance and a lower 6-minute walk distance than those without PAD, and maximal calf conductance was positively and independently associated with 6-minute walk distance within each group before and after adjusting for ABI, and for demographic, anthropometric, and comorbid variables.
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Affiliation(s)
- Andrew W Gardner
- Department of Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.,University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Polly S Montgomery
- Department of Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.,University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ming Wang
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Menglu Liang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - David N Proctor
- Department of Kinesiology, Penn State University, University Park, PA, USA
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Barden JM, Hoffert L, Ruf S, McCarville D, Kopriva D. The effect of peripheral arterial disease and intermittent claudication on gait regularity and symmetry. J Biomech 2022; 141:111205. [PMID: 35759975 DOI: 10.1016/j.jbiomech.2022.111205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 11/26/2022]
Abstract
Peripheral arterial disease (PAD) affects 20-30% of older adults and is associated with intermittent claudication (IC), which is walking-induced pain. This study compared the regularity and symmetry of gait between healthy older adults and adults with PAD, and between IC and non-IC conditions in the PAD group. Eighteen control (70.7 ± 6.3 years) and 11 PAD participants (67.0 ± 10.1 years) walked overground at a continuous, self-selected speed. A waist-mounted accelerometer determined step time, stride time, gait speed and mediolateral (ML), vertical (V) and anteroposterior (AP) gait regularity (step/stride) and symmetry. Correlations between ankle-brachial index (ABI) scores and PAD gait regularity/symmetry were also investigated. PAD step and stride times were greater (p < 0.01), while gait speed, ML and AP step regularity and ML and V stride regularity were significantly less than the controls (p < 0.05). There were no significant differences in gait symmetry. Within the PAD group, post-IC step/stride time and speed increased and decreased, respectively, (p < 0.05), while post-IC step and stride regularity were significantly less in all three directions (p < 0.01). Similarly, ML and V post-IC gait asymmetry increased significantly (p < 0.05). ABI was significantly correlated with pre-and post-IC vertical stride regularity (p < 0.01), and with pre- and post-IC ML gait symmetry (p < 0.05). The results demonstrate that gait regularity decreases as a result of PAD and IC. The association between gait regularity/symmetry and ABI should be investigated further, as it may have clinical application to the assessment of PAD severity.
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Affiliation(s)
- John M Barden
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada.
| | - Lucas Hoffert
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Sarah Ruf
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Don McCarville
- Division of Vascular Surgery, Saskatchewan Health Authority, Regina, SK, Canada.
| | - David Kopriva
- Division of Vascular Surgery, Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
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Calanca L, Lanzi S, Ney B, Berchtold A, Mazzolai L. Multimodal Supervised Exercise Significantly Improves Walking Performances Without Changing Hemodynamic Parameters in Patients With Symptomatic Lower Extremity Peripheral Artery Disease. Vasc Endovascular Surg 2020; 54:605-611. [PMID: 32691691 DOI: 10.1177/1538574420940090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We evaluated the outcome of multimodal supervised exercise training (SET) on walking performances and different hemodynamic parameters (ankle/toe-brachial index [ABI/TBI], and transcutaneous oxygen pressure [TcPO2]) in patients with symptomatic lower extremity peripheral artery disease (PAD). Whether hemodynamic parameters predict walking performances at baseline and following SET was also investigated. Fontaine stage II PAD's patients following a 3-month SET were retrospectively included. Hemodynamic parameters and walking performances (pain-free [PFWD], maximal [MWD], and 6-minute [6MWD] walking distance) were measured in each patient. Eighty-five symptomatic PAD patients were included. Following SET, PFWD, MWD, and 6MWD significantly increased (+142%, +94%, +14%; respectively; P ≤ .001). Toe-brachial index significantly increased (MD: 0.04 ± 0.01; P = .02), whereas ABI and TcPO2 did not change significantly. At baseline, patients with higher TBI and TcPO2 performed significantly better (PFWD: β = 0.25, P = .01 for TBI; PFWD: β = 0.30, P = .005, and MWD: β = 0.22, P = .04, for TcPO2). No significant relationship was observed at baseline between ABI and walking performances. Baseline values of hemodynamic parameters did not significantly correlate with changes in walking performances. Multimodal SET significantly improves walking performances. Following SET, no significant changes in ABI and TcPO2 were observed. Toe-brachial index values significantly improved after SET. However, this increase was very modest and its clinical relevance remains questionable. Although baseline TBI and supine TcPO2 values predict baseline walking performances, no association was found between baseline hemodynamic parameters and changes in walking performances following SET.
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Affiliation(s)
- Luca Calanca
- Division of Angiology, Heart and Vessel Department, 27213Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Division of Angiology, Heart and Vessel Department, 27213Lausanne University Hospital, Lausanne, Switzerland
| | - Barbara Ney
- Division of Angiology, Heart and Vessel Department, 27213Lausanne University Hospital, Lausanne, Switzerland
| | - André Berchtold
- Institute of Social Sciences & NCCR LIVES, 27213University of Lausanne, Lausanne, Switzerland
| | - Lucia Mazzolai
- Division of Angiology, Heart and Vessel Department, 27213Lausanne University Hospital, Lausanne, Switzerland
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Mezdad T, Henni S, Feuilloy M, Chauvet P, Schang D, Abraham P. Identification of new factors associated to walking impairment in patients with vascular-type claudication. Vascular 2018; 27:260-269. [PMID: 30442076 DOI: 10.1177/1708538118813708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Mechanisms of walking limitation in arterial claudication are incompletely elucidated. We aimed to identify new variables associated to walking limitation in patients with claudication. METHODS We retrospectively analyzed data of 1120 patients referred for transcutaneous exercise oxygen pressure recordings (TcpO2). The outcome measurement was the absolute walking time on treadmill (3.2 km/h, 10% slope). We used both: linear regression analysis and a non-linear analysis, combining support vector machines and genetic explanatory in 800 patients with the following resting variables: age, gender, body mass index, the presence of diabetes, minimal ankle to brachial index at rest, usual walking speed over 10 m (usual-pace), number of comorbid conditions, active smoking, resting heart rate, pre-test glycaemia and hemoglobin, beta-blocker use, and exercise-derived variables: minimal value of pulse oximetry, resting chest-TcpO2, decrease in chest TcpO2 during exercise, presence of buttock ischemia defined as a decrease from rest of oxygen pressure index ≤15 mmHg. We tested the models over 320 other patients. RESULTS Independent variables associated to walking time, by decreasing importance in the models, were: age, ankle to brachial index, usual-pace; resting TcpO2, body mass index, smoking, buttock ischemia, heart rate and beta-blockers for the linear regression analysis, and were ankle to brachial index, age, body mass index, usual-pace, decrease in chest TcpO2, smoking, buttock ischemia, glycaemia, heart rate for the non-linear analysis. Testing of models over 320 new patients gave r = 0.509 for linear and 0.575 for non-linear analysis (both p < 0.05). CONCLUSION Buttock ischemia, heart rate and usual-pace are new variables associated to walking time.
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Affiliation(s)
| | - Samir Henni
- 1 Vascular Medicine, University Hospital, Angers, France
| | | | | | | | - Pierre Abraham
- 4 Exercise and Sports Medicine, University Hospital, Angers, France.,5 INSERM 1083, CNRS 6015, LUNAM Université, Angers, France
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Relationship between walking capacity and ambulatory blood pressure in patients with intermittent claudication. Blood Press Monit 2018; 22:115-121. [PMID: 28195842 DOI: 10.1097/mbp.0000000000000243] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Patients with intermittent claudication (IC) often have high blood pressure (BP), which increases their cardiovascular risk. However, whether walking capacity is associated with BP levels in patients with IC remains unknown. Therefore, this study was designed to investigate whether the total walking distance is associated with ambulatory BP in patients with IC. PARTICIPANTS AND METHODS This was a cross-sectional study of 75 patients with IC (58 men; 17 women). A maximal treadmill test (Gardner protocol) was performed to assess total walking distance in these patients. Furthermore, ambulatory BP, heart rate, rate-pressure product, and BP load were obtained over a 24-h period. One-way analysis of variance and multiple linear regression were carried out. RESULTS Walking capacity was correlated negatively with the following: (i) asleep systolic BP, diastolic BP, mean BP and heart rate; (ii) 24-h, awake and asleep RPP; and (iii) awake and asleep systolic BP load (all P<0.05). These associations occurred irrespective of confounders such as age, sex, BMI, smoking status, and number of antihypertensive medications. CONCLUSION A better walking capacity is associated with lower ambulatory BP parameters in patients with IC.
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Walking Capacity Is Positively Related with Heart Rate Variability in Symptomatic Peripheral Artery Disease. Eur J Vasc Endovasc Surg 2016; 52:82-9. [DOI: 10.1016/j.ejvs.2016.03.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/30/2016] [Indexed: 01/16/2023]
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Sharath SE, Kougias P, Pisimisis G, Barshes NR. The impact of clinical, psychological, behavioral, social, and environmental factors on self-perceived symptom severity in a male cohort with intermittent claudication. J Vasc Surg 2016; 63:1296-1304.e4. [DOI: 10.1016/j.jvs.2015.11.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/06/2015] [Indexed: 01/06/2023]
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Bernal-Lopez MR, Peña D, Gomez-Martin P, Tinahones FJ, Gomez-Huelgas R. Cilostazol does not improve peripheral arterial disease-linked oxidative stress. Cardiovasc Ther 2015; 33:15-9. [PMID: 25393963 DOI: 10.1111/1755-5922.12100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIM Cilostazol is a drug widely used to treat peripheral arterial disease (PAD) in patients with advanced atherosclerosis. It is an inhibitor of platelet aggregation and causes arterial vasodilatation. It has been speculated that cilostazol might act to improve oxidative stress in these patients. METHODS We analyzed 25 patients with demonstrated lower limb peripheral arterial disease to determine whether lipid peroxidation (LPO) or total antioxidant capacity (TAC) were modified after 6 months of cilostazol treatment (postintervention phase) with respect to the basal phase. RESULTS Analysis of plasma samples determined that LPO levels decreased significantly over the postintervention phase (26±15 vs. 11±7 pM, P=0.0003). However, when TAC levels were analyzed, no significant differences were observed (0.80±0.21 vs. 0.85±0.17 mM, P=0.42). Under basal conditions, LPO showed a positive correlation to treatment as judged by the ankle-brachial index (r=0.800, P=0.002) as well as uric acid (r=0.508, P=0.03) and CRP (r=0.481, P=0.05) levels. In contrast, TAC negatively correlated with triglycerides (r=-0.879, P<0.0001) and microalbuminuria (r=-0.868, P<0.0001). In the postintervention phase, TAC negatively correlated with HbA1c (r=-0.570, P=0.02) and triglycerides (r=-0.864, P<0.0001). CONCLUSIONS Our data indicate that cilostazol treatment does not improve oxidative stress in PAD patients after 6 months of treatment. However, lipid peroxidation and total antioxidant capacity were affected by cilostrazol treatment, which could be related to altered reactive oxygen species production. Further research may be needed to determine the critical dose of cilostazol to clarify the protective role of this drug in PAD.
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Affiliation(s)
- M Rosa Bernal-Lopez
- Biomedical Research Laboratory, Internal Medicine Department, Biomedical Institute of Malaga (IBIMA), University Hospitals, Regional and Clinical Virgen de la Victoria of Malaga, Malaga, Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Hiatt WR, Armstrong EJ, Larson CJ, Brass EP. Pathogenesis of the limb manifestations and exercise limitations in peripheral artery disease. Circ Res 2015; 116:1527-39. [PMID: 25908726 DOI: 10.1161/circresaha.116.303566] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with peripheral artery disease have a marked reduction in exercise performance and daily ambulatory activity irrespective of their limb symptoms of classic or atypical claudication. This review will evaluate the multiple pathophysiologic mechanisms underlying the exercise impairment in peripheral artery disease based on an evaluation of the current literature and research performed by the authors. Peripheral artery disease results in atherosclerotic obstructions in the major conduit arteries supplying the lower extremities. This arterial disease process impairs the supply of oxygen and metabolic substrates needed to match the metabolic demand generated by active skeletal muscle during walking exercise. However, the hemodynamic impairment associated with the occlusive disease process does not fully account for the reduced exercise impairment, indicating that additional pathophysiologic mechanisms contribute to the limb manifestations. These mechanisms include a cascade of pathophysiological responses during exercise-induced ischemia and reperfusion at rest that are associated with endothelial dysfunction, oxidant stress, inflammation, and muscle metabolic abnormalities that provide opportunities for targeted therapeutic interventions to address the complex pathophysiology of the exercise impairment in peripheral artery disease.
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Affiliation(s)
- William R Hiatt
- From the Division of Cardiology, Department of Medicine (W.R.H., E.J.A.), CPC Clinical Research (W.R.H.), University of Colorado School of Medicine, Aurora; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, CA (C.J.L.); and Department of Medicine, Harbor-UCLA Center for Clinical Pharmacology, Torrance, CA (E.P.B.).
| | - Ehrin J Armstrong
- From the Division of Cardiology, Department of Medicine (W.R.H., E.J.A.), CPC Clinical Research (W.R.H.), University of Colorado School of Medicine, Aurora; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, CA (C.J.L.); and Department of Medicine, Harbor-UCLA Center for Clinical Pharmacology, Torrance, CA (E.P.B.)
| | - Christopher J Larson
- From the Division of Cardiology, Department of Medicine (W.R.H., E.J.A.), CPC Clinical Research (W.R.H.), University of Colorado School of Medicine, Aurora; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, CA (C.J.L.); and Department of Medicine, Harbor-UCLA Center for Clinical Pharmacology, Torrance, CA (E.P.B.)
| | - Eric P Brass
- From the Division of Cardiology, Department of Medicine (W.R.H., E.J.A.), CPC Clinical Research (W.R.H.), University of Colorado School of Medicine, Aurora; Cardiovascular & Metabolic Diseases Drug Discovery Unit, Takeda Pharmaceuticals, San Diego, CA (C.J.L.); and Department of Medicine, Harbor-UCLA Center for Clinical Pharmacology, Torrance, CA (E.P.B.)
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Ferreira NV, Cunha PJ, da Costa DI, dos Santos F, Costa FO, Consolim-Colombo F, Irigoyen MC. Association between functional performance and executive cognitive functions in an elderly population including patients with low ankle-brachial index. Clin Interv Aging 2015; 10:839-46. [PMID: 26005338 PMCID: PMC4427597 DOI: 10.2147/cia.s69270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Peripheral arterial disease, as measured by the ankle–brachial index (ABI), is prevalent among the elderly, and is associated with functional performance, assessed by the 6-minute walk test (6MWT). Executive cognitive function (ECF) impairments are also prevalent in this population, but no existing study has investigated the association between ECF and functional performance in an elderly population including individuals with low ABI. Aim To investigate the association between functional performance, as measured by the 6MWT, and loss in ECF, in an elderly sample including individuals with low ABI. Method The ABI group was formed by 26 elderly individuals with low ABI (mean ABI: 0.63±0.19), and the control group was formed by 40 elderly individuals with normal ABI (mean ABI: 1.08±0.07). We analyzed functional performance using the 6MWT, global cognition using the Mini-Mental State Examination (MMSE), and ECF using the Digit Span for assessing attention span and working memory, the Stroop Color Word Test (SCWT) for assessing information processing speed and inhibitory control/impulsivity, and the Controlled Oral Word Association Test (COWAT) for assessing semantic verbal fluency and phonemic verbal fluency. We also used a factor analysis on all of the ECF tests (global ECF). Results Before adjustment, the ABI group performed worse on global cognition, attention span, working memory, inhibitory control/impulsivity, semantic verbal fluency, and phonemic verbal fluency. After adjustment, the ABI group performance remained worse for working memory and semantic verbal fluency. In a simple correlation analysis including all of the subjects, the 6MWT was associated with global cognition, attention span, working memory, information processing speed, inhibitory control/impulsivity, semantic verbal fluency, and global ECF. After adjustment, all the associations remained statistically significant. Conclusion This study found an independent association between functional performance and ECF in an elderly population including low ABI individuals, showing that, in elderly populations with functional impairment, ECF may also be impaired.
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Affiliation(s)
- Naomi Vidal Ferreira
- Heart Institute, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paulo Jannuzzi Cunha
- Neuroimaging in Psychiatry Laboratory, Department of Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Fernando dos Santos
- Heart Institute, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil
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Santos ARMD, Miranda ADS, Ritti-Dias RM, Freitas CMSMD. Limitações para caminhar em idosos com claudicação intermitente: a religiosidade como mecanismo de superação da dor. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2014. [DOI: 10.1590/s1809-98232014000200013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Analisar a percepção sobre a dor durante a caminhada em idosos com claudicação intermitente e como eles utilizam a religiosidade para superar o sintoma doloroso. MÉTODOS: A amostra foi composta por dez integrantes de um programa de treinamento físico que apresentavam sintomas de claudicação intermitente. Foi traçado um perfil da população, contendo dados sociodemográficos e religiosos; e realizou-se entrevista com base em roteiro de entrevista semiestruturada. Utilizou-se o procedimento da estatística descritiva para os dados numéricos e as falas dos sujeitos foram submetidas ao software Analysis of Qualitative Data (AQUAD) e posteriormente analisadas por meio da análise de conteúdo temática. RESULTADOS: Os resultados evidenciaram que os sujeitos apresentaram sentimentos negativos frente à dor ao caminhar, tais como aborrecimento, tristeza e medo. Ao mesmo tempo, eles acreditavam que a religião e a crença da existência de um Ser Superior os ajudavam a superar a dor nas pernas. CONCLUSÃO: A fé e a religiosidade parecem funcionar como ferramentas de superação da dor durante a caminhada dos idosos com claudicação intermitente.
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Effect of surgical treatment on lipid peroxidation parameters and antioxidant status in the serum of patients with peripheral arterial disease. DISEASE MARKERS 2013; 35:647-52. [PMID: 24302809 PMCID: PMC3834664 DOI: 10.1155/2013/530946] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/16/2013] [Accepted: 10/17/2013] [Indexed: 11/17/2022]
Abstract
The various risk factors for peripheral arterial disease (PAD) are almost identical to those for atherosclerosis and include abnormal levels of lipids or lipoproteins. Lipid peroxidation parameters and total antioxidant capacity in the serum of male patients with PAD before surgery as well as 3–5 days and 7–10 days after surgery were measured. We also compared these parameters with those in a group of patients receiving simvastatin therapy. Concentrations of lipid hydroperoxides (LOOHs) and malondialdehyde, the total antioxidant capacity (assessed by ferric reducing antioxidant power assay), concentration of thiol (-SH) groups, and ceruloplasmin activity were determined spectrophotometrically in PAD patients treated surgically (Group I) or pharmacologically (Group II). The patients before surgical treatment had significantly higher concentrations of malondialdehyde but lower ceruloplasmin activity than those observed in Group II, treated with simvastatin. No significant differences before surgery in ferric reducing antioxidant power or thiol concentrations were found between the two groups. However, in Group I, both ferric reducing antioxidant power and thiol group concentrations decreased 3–5 days postoperatively, and ceruloplasmin activity increased 7–10 days after surgical treatment. The presented results demonstrate diverse oxidative stress responses to surgical treatment and confirm the beneficial effects of statin therapy in PAD.
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