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Stettler GR, Bouldin B, Rebo KA, Arafeh MOS, Carmichael SP, Mowery NT, Nunn AM. Pre-Injury Statin Exposure is Associated With Improved Outcomes in Injured Patients That Receive Whole Blood. Am Surg 2024:31348241265142. [PMID: 39033341 DOI: 10.1177/00031348241265142] [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: 07/23/2024]
Abstract
Introduction: Whole blood (WB) is associated with improved mortality while lowering blood product utilization. Furthermore, statin medications are associated with favorable outcomes in traumatic brain injury and risk reduction of venous thromboembolism. However, the use of statin medications has not been evaluated in those receiving WB. The objective of this study is to determine the effects of pre-injury statin exposure on patients receiving WB.Methods: Patients that underwent WB first resuscitation and received pre-injury statins were compared to those that did not receive pre-injury statins. Demographics as well as complication rates, blood product transfusion volumes, and mortality were evaluated. Univariate and multivariable analyses were used to determine independent predictors of mortality.Results: In the study period, 785 patients received WB as part of their resuscitation. One hundred and thirty five patients (17.3%) took statin medications prior to injury. Patients that were exposed to a pre-injury statin had a lower mortality rate than those that were not exposed (21.5% vs 32.5%, P = .01). After adjusting for imbalances, age, ISS, Glasgow Coma Scale, admission systolic blood pressures, and pre-injury statin use were independent predictors of mortality following multiple logistic regression. When evaluating outcomes based on statin intensity, the use of high-intensity statins was associated with lower mortality (OR: .37, 95% CI: .13-.93), whereas moderate and low-intensity statins were not.Conclusion: In patients resuscitated with WB, pre-injury statins use was associated with improved outcomes. Specifically, patients that received high-intensity pre-injury statins appeared to be the population that benefited.
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Affiliation(s)
- Gregory R Stettler
- Department of Surgery, Division of Trauma and Acute Care Surgery, Atrium Health Wake Forest Baptist Hospital, Winston-Salem, NC, USA
| | - Bethany Bouldin
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kristin A Rebo
- Department of Pharmacy, Atrium Health Wake Forest Baptist Hospital, Winston-Salem, NC, USA
| | - Mohamed-Omar S Arafeh
- Department of Surgery, Division of Trauma and Acute Care Surgery, Atrium Health Wake Forest Baptist Hospital, Winston-Salem, NC, USA
| | - Samuel P Carmichael
- Department of Surgery, Division of Trauma and Acute Care Surgery, Atrium Health Wake Forest Baptist Hospital, Winston-Salem, NC, USA
| | - Nathan T Mowery
- Department of Surgery, Division of Trauma and Acute Care Surgery, Atrium Health Wake Forest Baptist Hospital, Winston-Salem, NC, USA
| | - Andrew M Nunn
- Department of Surgery, Division of Trauma and Acute Care Surgery, Atrium Health Wake Forest Baptist Hospital, Winston-Salem, NC, USA
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2
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Yang Q, Sun S, Cui LB, Gao S, Gu Z, Fang Z, Zhang Y, Chen S, Sun N, Wang Y, Cao F. Ischemic cardio-cerebrovascular disease and all-cause mortality in Chinese elderly patients: a propensity-score matching study. Eur J Med Res 2024; 29:330. [PMID: 38879523 PMCID: PMC11179225 DOI: 10.1186/s40001-024-01929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Ischemic cardio-cerebrovascular disease is the leading cause of mortality worldwide. However, studies focusing on elderly and very elderly patients are scarce. Hence, our study aimed to characterize and investigate the long-term prognostic implications of ischemic cardio-cerebrovascular diseases in elderly Chinese patients. METHODS This retrospective cohort study included 1026 patients aged ≥ 65 years who were categorized into the mono ischemic cardio-cerebrovascular disease (MICCD) (either coronary artery disease or ischemic stroke/transient ischemic attack) (n = 912) and the comorbidity of ischemic cardio-cerebrovascular disease (CICCD) (diagnosed with both coronary artery disease and ischemic stroke/transient ischemic attack at admission) (n = 114). The primary outcome was all-cause death. The mortality risk was evaluated using the Cox proportional hazards risk model with multiple adjustments by conventional and propensity-score-based approaches. RESULTS Of the 2494 consecutive elderly patients admitted to the hospital, 1026 (median age 83 years [interquartile range]: 76.5-86.4; 94.4% men) met the inclusion criteria. Patients with CICCD consisted mostly of very elderly (79.2% vs. 66.1%, P < 0.001) individuals with a higher burden of comorbidities. Over a median follow-up of 10.4 years, 398 (38.8%) all-cause deaths were identified. Compared with the MICCD group, the CICCD group exhibited a higher adjusted hazard ratio (HR) (95% confidential interval, CI) of 1.71 (1.32-2.39) for long-term mortality after adjusting for potential confounders. The sensitivity analysis results remained robust. After inverse probability of treatment weighting (IPTW) modeling, the CICCD group displayed an even worse mortality risk (IPTW-adjusted HR: 2.07; 95% CI 1.47-2.90). In addition, anemia (adjusted HR: 1.48; 95% CI 1.16-1.89) and malnutrition (adjusted HR: 1.43; 95% CI 1.15-1.78) are also independent risk factors for all-cause mortality among elderly and very elderly patients. CONCLUSIONS Our results thus suggest that elderly patients with ischemic cardio-cerebrovascular disease and anemia or malnutrition may have higher mortality, which may be predicted upon admission. These findings, however, warrant further investigation.
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Affiliation(s)
- Qian Yang
- Medical School of Chinese PLA, Beijing, 100039, China
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shasha Sun
- The Fifth Department of Cadre Health Care, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Long-Biao Cui
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shan Gao
- Medical School of Chinese PLA, Beijing, 100039, China
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhenghui Gu
- Medical School of Chinese PLA, Beijing, 100039, China
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhiyi Fang
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- School of Medicine, Nankai University, 94 Weijin Road, Tianjin, 30071, China
| | - Yingjie Zhang
- Medical School of Chinese PLA, Beijing, 100039, China
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Sijia Chen
- Medical School of Chinese PLA, Beijing, 100039, China
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
| | - Naiyuan Sun
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- School of Medicine, Nankai University, 94 Weijin Road, Tianjin, 30071, China
| | - Yabin Wang
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Feng Cao
- Department of Cardiology, The Second Medical Center & National Clinical Research, Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
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3
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Braun SK, Jorge DW, Pedron VF. Influence of Preprocedural Statin Usage on Primary Patency and Amputation in Patients Undergoing Lower Limb Peripheral Angioplasty. Ann Vasc Surg 2024; 106:213-226. [PMID: 38821472 DOI: 10.1016/j.avsg.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Peripheral arterial disease can progress to critical limb ischemia, which is associated with high amputation rates and requires revascularization. The endovascular approach has lower long-term patency because of restenosis due to neointimal hyperplasia. Statins are significantly advantageous for patients undergoing percutaneous interventions; however, only few studies have reported surgical improvements with statin therapy after endovascular treatment in such patients. This retrospective cohort study assessed the effects of preprocedural statins on lower limb arterial angioplasty outcomes by evaluating patency and amputation rates and comparing with those without statins. METHODS Patients who underwent percutaneous transluminal angioplasty of the lower limbs for critical ischemia of the lower limbs or for limiting claudication were included in this retrospective cohort study. Patients were categorized according to statin use prior to and during hospitalization. Patient demographics, lesion morphology, primary patency, and limb salvage rates were compared between these groups. Statistical analyses were performed using Kaplan-Meier and multivariate regression analysis. RESULTS A total of 178 patients undergoing endovascular intervention by critical ischemia or limiting claudication were included. Approximately 80% of the procedures were ballon angioplasty. Primary patency was 73% in 1 year and preprocedural statin usage was not associated with improved primary patency rates (P = 0.2798). After adjusting the amputation outcomes for pre-established variables, such as prehospitalization statin use, diabetes, procedure indication, disease location, Trans-Atlantic Inter-Society Consensus classification, and current smoking, there was no statistically significant difference associated with preprocedural statin use in primary patency (hazard ratio: 0.87 [0.33-2.29], P = 0.79) or amputation (hazard ratio: 0.70 [0.40-1.23], P = 0.22). CONCLUSIONS The use of preprocedural statin did not improve primary patency or amputation rates in patients undergoing peripheral angioplasty.
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Affiliation(s)
- Stela Karine Braun
- Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil; Surgery Department, Universidade Franciscana, Santa Maria, Rio Grande do Sul, Brazil.
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Lu CR, Lu SY, Lin SY, Yip HT, Liu CH, Hsu KC, Chang SS. Protective Effects of Statins on Limb and Cardiovascular Outcomes in Patients with Peripheral Artery Disease and End-Stage Renal Disease. ACTA CARDIOLOGICA SINICA 2023; 39:755-764. [PMID: 37720404 PMCID: PMC10499954 DOI: 10.6515/acs.202309_39(5).20230118a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/18/2023] [Indexed: 09/19/2023]
Abstract
Background Previous studies have reported that statins have inconsistent and marginal cardiovascular (CV) benefits in patients with end-stage renal disease (ESRD). However, whether statins play a secondary preventive role in patients with peripheral artery disease (PAD) and ESRD remains unclear. Objectives This study aimed to compare the long-term clinical outcomes between statin users and nonusers with PAD and ESRD. Methods This retrospective cohort study assessed the long-term protective effects of statins using data from the National Health Insurance Research Database in Taiwan. Propensity score matching was performed according to sex, age, index year, related comorbidities, and medications. The main outcomes were limb events and major adverse CV events (MACEs). Results The statin user group (n = 4,460) was compared with the propensity score-matched statin nonuser group (n = 4,460). The mean age of the matched patients was 64 years, and 40% of the patients were men. The baseline characteristics of the groups were well-balanced. The overall limb event and MACE rates were not different between the two groups. However, the statin user group had lower rates of limb amputation [adjusted hazard ratio (aHR): 0.85, 95% confidence interval (CI): 0.73-0.99], stroke (aHR: 0.71, 95% CI: 0.62-0.83), CV death (aHR: 0.46, 95% CI: 0.32-0.66), and all-cause death (aHR: 0.45, 95% CI: 0.42-0.48) despite having a higher rate of percutaneous transluminal angioplasty for PAD. Conclusions This population-based retrospective cohort study demonstrated that statin therapy was associated with a lower risk of limb amputation, nonfatal stroke, CV death, and all-cause death in patients with PAD and ESRD.
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Affiliation(s)
- Chiung-Ray Lu
- Division of Cardiovascular Medicine, China Medical University Hospital
| | - Shang-Yeh Lu
- Division of Cardiovascular Medicine, China Medical University Hospital
| | - Shi-Yi Lin
- School of Medicine, College of Medicine
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University
- Division of Nephrology and Kidney Institute
| | - Hei-Tung Yip
- Management Office for Health Data, China Medical University Hospital
- College of Medicine
| | - Chia-Hao Liu
- Division of Cardiovascular Medicine, China Medical University Hospital
| | - Kai-Cheng Hsu
- Artificial Intelligence Center for Medical Diagnosis, China Medical University
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Sheng Chang
- Division of Cardiovascular Medicine, China Medical University Hospital
- School of Medicine, College of Medicine
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5
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Bierowski M, Galanis T, Majeed A, Mofid A. Peripheral Artery Disease: Overview of Diagnosis and Medical Therapy. Med Clin North Am 2023; 107:807-822. [PMID: 37541709 DOI: 10.1016/j.mcna.2023.05.007] [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: 08/06/2023]
Abstract
Peripheral artery disease (PAD) affects approximately 230 million people worldwide and is associated with an increased risk of major adverse cardiovascular and limb events. Even though this condition is considered a cardiovascular equivalent, it remains an underrecognized and undertreated entity. Antiplatelet and statin therapy, along with smoking cessation, are the foundations of therapy to reduce adverse events but are challenging to fully implement in this patient population. Race and socioeconomic status also have profound impacts on PAD outcomes.
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Affiliation(s)
- Matthew Bierowski
- Internal Medicine, Thomas Jefferson University Hospital, 1025 Walnut Street, Philadelphia, PA 19107, USA
| | - Taki Galanis
- Division Vascular Medicine, Jefferson Vascular Center, Sidney Kimmel Medical College, Philadelphia, PA, USA.
| | - Amry Majeed
- Internal Medicine, Thomas Jefferson University Hospital, 1025 Walnut Street, Philadelphia, PA 19107, USA
| | - Alireza Mofid
- Vascular Surgery, Thomas Jefferson University Hospital, 111 South 11th Street, Suite 6210 Gibbon, Philadelphia, PA 19107, USA
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McNeil S, Waller K, Poy Lorenzo YS, Mateevici OC, Telianidis S, Qi S, Churilov I, MacIsaac RJ, Galligan A. Detection, management, and prevention of diabetes-related foot disease in the Australian context. World J Diabetes 2023; 14:942-957. [PMID: 37547594 PMCID: PMC10401446 DOI: 10.4239/wjd.v14.i7.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/06/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023] Open
Abstract
Diabetes-related foot disease (DFD) is a widely feared complication among people who live with diabetes. In Australia and globally, rates of disability, cardio-vascular disease, lower extremity amputation, and mortality are significantly increased in patients with DFD. In order to understand and prevent these outcomes, we analyse the common pathogenetic processes of neuropathy, arterial disease, and infection. The review then summarises important management considerations through the interdisciplinary lens. Using Australian and international guidelines, we offer a stepwise, evidence-based practical approach to the care of patients with DFD.
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Affiliation(s)
- Scott McNeil
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
| | - Kate Waller
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Podiatry, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
| | - Yves S Poy Lorenzo
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Infectious Diseases Unit, Department of Medicine, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Pharmacy, St Vincent’s Hospital Melbourne, Fitzroy 3065, Australia
- Department of Medicine, St Vincent’s Hospital Melbourne, University of Melbourne, Fitzroy 3065, Victoria, Australia
| | - Olimpia C Mateevici
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Infectious Diseases Unit, Department of Medicine, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
| | - Stacey Telianidis
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Vascular Surgery, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
| | - Sara Qi
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Vascular Surgery, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
| | - Irina Churilov
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Medicine, St Vincent’s Hospital Melbourne, University of Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Rehabilitation Medicine, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
| | - Richard J MacIsaac
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Medicine, St Vincent’s Hospital Melbourne, University of Melbourne, Fitzroy 3065, Victoria, Australia
- the Australian Centre for Accelerating Diabetes Innovations, School of Medicine, University of Melbourne, Parkville 3010, Victoria, Australia
| | - Anna Galligan
- High Risk Foot Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
- Department of Endocrinology and Diabetes, St Vincent’s Hospital Melbourne, Fitzroy 3065, Victoria, Australia
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7
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Enea I, Martelli E. Focus on the Prevention of Acute Limb Ischemia: Centrality of the General Practitioner from the Point of View of the Internist. J Clin Med 2023; 12:jcm12113652. [PMID: 37297848 DOI: 10.3390/jcm12113652] [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: 04/01/2023] [Revised: 05/01/2023] [Accepted: 05/15/2023] [Indexed: 06/12/2023] Open
Abstract
The thrombotic mechanism, being common to peripheral arterial disease (PAD), acute myocardial infarction (AMI), and stroke, is responsible for the highest number of deaths in the western world. However, while much has been done for the prevention, early diagnosis, therapy of AMI and stroke, the same cannot be said for PAD, which is a negative prognostic indicator for cardiovascular death. Acute limb ischemia (ALI) and chronic limb ischemia (CLI) are the most severe manifestations of PAD. They both are defined by the presence of PAD, rest pain, gangrene, or ulceration and we consider ALI if symptoms last less than 2 weeks and CLI if they last more than 2 weeks. The most frequent causes are certainly atherosclerotic and embolic mechanisms and, to a lesser extent, traumatic or surgical mechanisms. From a pathophysiological point of view, atherosclerotic, thromboembolic, inflammatory mechanisms are implicated. ALI is a medical emergency that puts both limb and the patient's life at risk. In patients over age 80 undergoing surgery, mortality remains high reaching approximately 40% as well as amputation approximately 11%. The purpose of this paper is to summarize the scientific evidence on the possibilities of primary and secondary prevention of ALI and to raise awareness among doctors involved in the management of ALI, in particular by describing the central role of the general practitioner.
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Affiliation(s)
- Iolanda Enea
- Emergency Department, S. Anna and S. Sebastiano Hospital, 81100 Caserta, Italy
| | - Eugenio Martelli
- Division of Vascular Surgery, Department of Cardiovascular Science, S. Anna and S. Sebastiano Hospital, Campania, 81100 Caserta, Italy
- Department of General and Specialist Surgery Paride Stefanini, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Medicine and Surgery School of Medicine, Saint Camillus International University of Health Science, 00131 Rome, Italy
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8
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Kubiak T, Sitruk J, Durivage A, Khider L, Mohamedi N, Détriché G, Messas E, Mirault T, Goudot G. Role of the advanced nurse practitioner within the vascular team: A qualitative study of vascular physicians and nurses. Front Public Health 2023; 11:1070403. [PMID: 37064660 PMCID: PMC10098095 DOI: 10.3389/fpubh.2023.1070403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/07/2023] [Indexed: 04/03/2023] Open
Abstract
Objective To assess the perception of Advanced Nurse Practitioners (ANP) by physicians and nurses in vascular medicine. As the status of ANP in France was recently enacted by law in 2018, we aimed to investigate physicians and nurses working with patients suffering from Peripheral Artery Disease (PAD) to gather their opinions and draw the cooperation outlines these practitioners could have with an ANP. Methods A qualitative study based on in-depth interviews was conducted among healthcare practitioners taking care of patients with PAD: 10 physicians working either in a private practice settings or hospital settings or both, and eight nurses working within a hospital inpatients vascular unit. Verbatim responses were extracted and coded according to a continuous thematization method. Results Three main features emerged from participants' responses. Vascular medicine has a specific organization with a significant lack of time and staff to fulfill the mission regarding patients' severity of illness. Second, the ANP is wanted to fill part of this gap. The expected benefits include a smoother care pathway and increased capacity for cardiovascular education and prevention, especially during consultations. Lastly, some clarification is required to integrate such new practitioners within vascular teams already in place. Conclusion Advanced nurse practitioners could be the missing link in a "Vascular team" by creating a continuum in the care of patients with PAD, ensuring clinical assessment, nursing supervision, adverse event screening, and renewing drug prescriptions with the required adaptations while ensuring essential part of therapeutic education adapted to each patient.
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Affiliation(s)
- Thibaut Kubiak
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| | - Jonas Sitruk
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
- Université Paris Cité, INSERM U970 PARCC, Paris, France
| | - Andréanne Durivage
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Lina Khider
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| | - Nassim Mohamedi
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| | - Grégoire Détriché
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
| | - Emmanuel Messas
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
- Université Paris Cité, INSERM U970 PARCC, Paris, France
| | - Tristan Mirault
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
- Université Paris Cité, INSERM U970 PARCC, Paris, France
| | - Guillaume Goudot
- Vascular Medicine Department, Georges-Pompidou European Hospital, Assistance Publique–Hôpitaux de Paris (AP–HP), Paris, France
- Université Paris Cité, INSERM U970 PARCC, Paris, France
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9
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Keramat S, Sharebiani H, Patel M, Fazeli B, Stanek A. The Potential Role of Antioxidants in the Treatment of Peripheral Arterial Disease: A Systematic Review. Antioxidants (Basel) 2022; 11:2126. [PMID: 36358498 PMCID: PMC9686635 DOI: 10.3390/antiox11112126] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/25/2022] [Indexed: 07/30/2023] Open
Abstract
Peripheral arterial disease (PAD) has a worldwide prevalence and is a significant cause of cardiovascular morbidity and mortality. Due to its high prevalence and higher rates of ischemic cardiovascular and lower-extremity events, its treatment is essential. Increased levels of oxidative stress cause disease. This review aimed to evaluate different studies of antioxidant treatments for PAD patients. A systematic search for relevant studies was performed on the PubMed, SCOPUS, and ScienceDirect databases, and 18 studies fulfilled the inclusion criteria. In total, 16.6% of the studies used natural antioxidants, and 83.3% used synthetic antioxidants. The reviewed studies show that natural antioxidants were completely effective in treating PAD, and synthetic antioxidants showed effective results in only 53% of the studies. A less-than-optimal pro-oxidant-antioxidant balance does not improve the symptoms of PAD. In conclusion, antioxidants in their natural forms are more effective for PAD patients, and ensuring the optimal pro-oxidant-antioxidant balance is an effective method for managing treatment with antioxidants.
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Affiliation(s)
- Shayan Keramat
- Vascular Independent Research and Education, European Foundation, 20157 Milan, Italy
- Department of Research and Biobanking, Buerger’s Disease Non-Governmental Organization, Mashhad 9183785195, Iran
| | - Hiva Sharebiani
- Vascular Independent Research and Education, European Foundation, 20157 Milan, Italy
- Department of Research and Biobanking, Buerger’s Disease Non-Governmental Organization, Mashhad 9183785195, Iran
| | - Malay Patel
- Vascular Independent Research and Education, European Foundation, 20157 Milan, Italy
- Department of Vascular Surgery, Apollo CVHF, Heart Institute, Ahmedabad 380059, India
| | - Bahare Fazeli
- Vascular Independent Research and Education, European Foundation, 20157 Milan, Italy
- Department of Research and Biobanking, Buerger’s Disease Non-Governmental Organization, Mashhad 9183785195, Iran
| | - Agata Stanek
- Vascular Independent Research and Education, European Foundation, 20157 Milan, Italy
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-902 Bytom, Poland
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10
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Shen Y, Wang XQ, Dai Y, Wang YX, Zhang RY, Lu L, Ding FH, Shen WF. Diabetic dyslipidemia impairs coronary collateral formation: An update. Front Cardiovasc Med 2022; 9:956086. [PMID: 36072863 PMCID: PMC9441638 DOI: 10.3389/fcvm.2022.956086] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Coronary collateralization is substantially impaired in patients with type 2 diabetes and occlusive coronary artery disease, which leads to aggravated myocardial ischemia and a more dismal prognosis. In a diabetic setting, altered serum lipid profiles and profound glycoxidative modification of lipoprotein particles induce endothelial dysfunction, blunt endothelial progenitor cell response, and severely hamper growth and maturation of collateral vessels. The impact of dyslipidemia and lipid-lowering treatments on coronary collateral formation has become a topic of heightened interest. In this review, we summarized the association of triglyceride-based integrative indexes, hypercholesterolemia, increased Lp(a) with its glycoxidative modification, as well as quantity and quality abnormalities of high-density lipoprotein with impaired collateral formation. We also analyzed the influence of innovative lipid-modifying strategies on coronary collateral development. Therefore, clinical management of diabetic dyslipidemia should take into account of its effect on coronary collateralization in patients with occlusive coronary artery disease.
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Affiliation(s)
- Ying Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao Qun Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Dai
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Xuan Wang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Yan Zhang
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Lin Lu
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Hua Ding
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Feng Hua Ding,
| | - Wei Feng Shen
- Department of Cardiovascular Medicine, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
- Institute of Cardiovascular Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wei Feng Shen,
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Role of Lipid-Lowering Therapy in Peripheral Artery Disease. J Clin Med 2022; 11:jcm11164872. [PMID: 36013107 PMCID: PMC9410277 DOI: 10.3390/jcm11164872] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/05/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Atherosclerosis is a multifactorial, lipoprotein-driven condition that leads to plaque formation within the arterial tree, leading to subsequent arterial stenosis and thrombosis that accounts for a large burden of cardiovascular morbidity and mortality globally. Atherosclerosis of the lower extremities is called peripheral artery disease and is a major cause of loss in mobility, amputation, and critical limb ischemia. Peripheral artery disease is a common condition with a gamut of clinical manifestations that affects an estimated 10 million people in the United States of America and 200 million people worldwide. The role of apolipoprotein B-containing lipoproteins, such as LDL and remnant lipoproteins in the development and progression of atherosclerosis, is well-established. The focus of this paper is to review existing data on lipid-lowering therapies in lower extremity atherosclerotic peripheral artery disease.
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Santoni M, Monteiro FSM, Massari F, Abahssain H, Aurilio G, Molina-Cerrillo J, Myint ZW, Zabalza IO, Battelli N, Grande E. Statins and renal cell carcinoma: Antitumor activity and influence on cancer risk and survival. Crit Rev Oncol Hematol 2022; 176:103731. [PMID: 35718065 DOI: 10.1016/j.critrevonc.2022.103731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/29/2022] [Indexed: 12/13/2022] Open
Abstract
Statins are commonly prescribed to reduce plasma cholesterol levels and risk of cardiovascular events and mortality. Statin exposure may have cancer-preventive properties in some solid tumors, including Renal Cell Carcinoma (RCC). Emerging evidences show that statins can inhibit RCC cell growth by inducing cell cycle arrest and apoptosis in a dose- and time-dependent manner. In addition, statins inhibit the phosphorylation of AKT, mammalian target of rapamycin (mTOR), and ERK leading to reduced motility of RCC cells. Interestingly, the potential impact of concomitant statin intake has been recently evaluated in RCC patients treated by targeted therapy or immunotherapy. In this review, we illustrate the most recent data on the preclinical activity of statins in Renal Cell Carcinoma models and discuss the impact of their use on the prevention and survival of patients affected by this tumor.
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Affiliation(s)
- Matteo Santoni
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy.
| | - Fernando Sabino M Monteiro
- Latin American Cooperative Oncology Group - LACOG, Brazil; Oncology and Hematology Department, Hospital Santa Lucia, SHLS 716 Cj. C, Brasília, DF 70390-700, Brazil
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni - 15, Bologna, Italy
| | - Halima Abahssain
- Medicine and Pharmacy Faculty, National Institute of Oncology, Medical Oncology Unit, Mohamed V University, Rabat, Morocco
| | - Gaetano Aurilio
- Medical Oncology Division of Urogenital and Head and Neck Tumours, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Zin W Myint
- Markey Cancer Center, University of Kentucky, Lexington, KY, 40536-0293, USA; Division of Medical Oncology, University of Kentucky, Lexington, KY, USA
| | | | - Nicola Battelli
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy
| | - Enrique Grande
- Department of Medical Oncology, MD Anderson Cancer Center Madrid, Madrid, Spain
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