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Watanabe Y. Fundamentals of utilizing upstroke time and percentage mean arterial pressure of ankle pulse volume recording as cardiovascular indexes. Hypertens Res 2024; 47:2091-2093. [PMID: 38811825 DOI: 10.1038/s41440-024-01738-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 05/31/2024]
Affiliation(s)
- Yoshiko Watanabe
- Department of General Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
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2
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Adou C, Magne J, Gazere N, Aouida M, Chastaingt L, Aboyans V. Global epidemiology of lower extremity artery disease in the 21st century (2000-21): a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:803-811. [PMID: 38079162 DOI: 10.1093/eurjpc/zwad381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 02/06/2024]
Abstract
AIMS The epidemiology of lower extremity artery disease (LEAD) is evolving. This meta-analysis of aggregate data aimed to (i) determine the global prevalence of LEAD and by regions in the 21st century and (ii) update the associated risk factors in this period. METHODS AND RESULTS A systematic literature review was performed through PubMed, Cochrane, Scopus, Science Direct, and Google Scholar databases, restricted to general population studies between January 2000 and September 2021, with LEAD defined by a low (≤0.90) ankle-brachial index. The Newcastle-Ottawa Scale was used to evaluate the quality of the articles before data extraction. Due to high heterogeneity, the random effect model was applied to this meta-analysis. Among 1418 references, 38 studies (127 961 participants) were retained. The global prevalence in adults, mostly ≥40 years, was estimated at 9.7% [95% confidence interval (CI): 7.1-12.4], higher in women (10.2%) than in men (8.8%), increasing sharply with age. The highest prevalence was found in South-Central Asia (14.5%) and the lowest in North America (5.6%). Significant associations were found between LEAD and current [odds ratio (OR) = 1.9, 95% CI: 1.4-2.5] and past smoking (OR = 1.6, 95% CI: 1.3-1.9) and between LEAD and diabetes (OR = 2.3, 95% CI: 2.0-2.8). Hypertension was significantly associated with LEAD (OR = 2.3, 95% CI: 1.9-2.8) and in particular in South America (OR = 4.0). Obesity (OR = 1.5, 95% CI: 1.2-1.8) and hypercholesterolaemia ≥200 mg/dL (OR = 1.9, 95% CI: 1.3-2.8) were also significantly associated with LEAD. CONCLUSION This meta-analysis highlights a currently high prevalence of LEAD worldwide, with substantial differences in global regions and between sexes. The strongest associations were found with metabolic risk factors.
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Affiliation(s)
- Caroline Adou
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Julien Magne
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Nana Gazere
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Maissa Aouida
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
| | - Lucie Chastaingt
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
- Department of Vascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges, France
| | - Victor Aboyans
- EpiMaCT Research Unit U1094 Inserm U270 IRD EpiMaCT, School of Medicine, Limoges University, 2ave Marcland, 87025 Limoges, France
- Department of Cardiology, Dupuytren University Hospital, 16 rue Bernard Descottes, 87042 Limoges, France
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3
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Kato T, Torii S, Nakamura N, Aihara K, Terabe Y, Iida O, Tokuda T, Nakama T, Kawahara Y, Miyamoto J, Saito T, Kamioka N, Murakami T, Ijichi T, Natsumeda M, Tanaka S, Ohno Y, Nakazawa G, Watanabe H, Ikari Y. Pathological Analysis of Medial and Intimal Calcification in Lower Extremity Artery Disease: Impact of Hemodialysis. JACC. ADVANCES 2023; 2:100656. [PMID: 38938733 PMCID: PMC11198496 DOI: 10.1016/j.jacadv.2023.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 06/29/2024]
Abstract
Background The prevalence and degree of lower extremity artery disease in hemodialysis (HD) patients is higher than in the general population. However, the pathological features have not yet been evaluated. Objectives The aim of the study was: 1) to compare lesion characteristics of lower extremity artery disease in HD vs non-HD patients; and 2) to determine factors associated with severe medial calcification. Methods Seventy-seven lower limb arteries were assessed from 36 patients (median age 77 years; 23 men; 21 HD and 15 non-HD) who underwent autopsy or lower limb amputation. Arteries were serially cut at 3- to 4-mm intervals creating 2,319 histological sections. Morphometric analysis and calcification measurements were performed using ZEN software. Calcification with a circumferential angle (arc) ≥180° was defined as severe calcification. Multivariable logistic regression was used to identify risk factors for severe medial calcification. Results The degree of the medial calcification arc was significantly higher in the HD group compared to the non-HD group (P < 0.0001). In the multivariable analysis, HD was associated with severe medial calcification in below-the-knee lesions (OR: 17.1; P = 0.02). The degree of intimal calcification in above-the-knee lesions was also significantly higher in HD patients with a higher prevalence of advanced atherosclerotic plaque (P = 0.02). The prevalence of severe bone formation was more common in the HD patients (P = 0.01). Conclusions Hemodialysis patients demonstrated a higher degree of medial and intimal calcification compared with non-HD patients. The difference was more prominent in the medial calcification of below-the-knee lesions.
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Affiliation(s)
- Tsukasa Kato
- Department of Cardiology, Akita University School of Medicine, Akita, Japan
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Norihito Nakamura
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Kazuki Aihara
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yuta Terabe
- Kasukabe Chuo General Hospital, Limb Salvage Center, Kasukabe, Japan
| | - Osamu Iida
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - Takahiro Tokuda
- Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
- Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Yo Kawahara
- Department of Cardiology, Isehara Kyodo Hospital, Isehara, Japan
| | - Junichi Miyamoto
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Takafumi Saito
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Norihiko Kamioka
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tsutomu Murakami
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Takeshi Ijichi
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Makoto Natsumeda
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Shigemitsu Tanaka
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Yohei Ohno
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Gaku Nakazawa
- Kindai University Faculty of Medicine, Department of Cardiology, Osaka, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Akita University School of Medicine, Akita, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
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4
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Kayama T, Sano M, Inuzuka K, Katahashi K, Yata T, Yamanaka Y, Naruse E, Yamamoto N, Takeuchi H, Unno N. A Pilot Study Investigating the Use of Regional Oxygen Saturation as a Predictor of Ischemic Wound Healing Outcome after Endovascular Treatment in Patients with Chronic Limb-Threatening Ischemia. Ann Vasc Dis 2021; 14:23-30. [PMID: 33786096 PMCID: PMC7991714 DOI: 10.3400/avd.oa.20-00132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To determine the prognostic value of regional tissue oxygenation saturation (rSO2) for ulcer healing after endovascular treatment (EVT) of peripheral arterial disease (PAD). Materials and Methods: Among PAD patients, 34 patients with chronic limb-threatening ischemia underwent EVT for limb salvage. We retrospectively analyzed the cutoff rSO2 values on postoperative day 1 to predict ulcer healing and patient prognosis. Skin perfusion pressure (SPP) and transcutaneous oxygen pressure (TcPO2) were also used to assess wound healing. Results: A finger-mounted tissue oximeter can easily measure rSO2 on the dorsal foot. Among the 34 patients, the ulcer healed in 25, and no changes were observed in 2 patients at 1 month after EVT. However, 7 patients needed major amputation at the same time. Wound healing was achieved in all patients with rSO2≥50%. With this cutoff, the sensitivity and specificity of the new device for wound healing were 100% and 64%, respectively. In all the wound healing cases, SPP was ≥45 mmHg, and TcPO2 was ≥40 mmHg. Conclusion: To assess limb ischemia, rSO2 can be measured quickly and easily using this device. We suggest that an rSO2>50% shows good prognosis for ulcer healing.
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Affiliation(s)
- Takafumi Kayama
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Masaki Sano
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kazunori Inuzuka
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kazuto Katahashi
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Tatsuro Yata
- Division of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
| | - Yuta Yamanaka
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Ena Naruse
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Naoto Yamamoto
- Division of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
| | - Hiroya Takeuchi
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Naoki Unno
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Division of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
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5
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Akpan IS, Enabulele O, Adewole AJ. An Overview of Peripheral Artery Disease in the Elderly: A Study in a Tertiary Hospital Southern Nigeria. Niger Med J 2020; 61:1-5. [PMID: 32317813 PMCID: PMC7113815 DOI: 10.4103/nmj.nmj_142_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/22/2019] [Accepted: 12/14/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The incidence of Peripheral Artery Disease (PAD), one of the manifestations of atherosclerosis, is increasing worldwide with significant effects on the quality of life. The disease is a strong prognostic marker for future cardiovascular events in people over 60 years, but relatively little is known about the condition among the elderly in sub-Saharan Africa. OBJECTIVE The objective of this study was to determine the prevalence and pattern of peripheral artery disease in elderly patients. Materials and Methods: A cross-sectional hospital-based study was carried out among elderly patients aged 60 years and above attending the Geriatric Clinic of the Department of Family Medicine of University of Benin Teaching Hospital, Edo State, Nigeria, from September to November 2017. Using systematic random sampling technique, 370 respondents were recruited from a sampling frame of 2160 respondents and a sampling fraction of 6. A structured questionnaire was administered to collect data on sociodemographic characteristics, lifestyle variable, and medical history. The ankle-brachial index (ABI) and toe-brachial index (TBI) were used to assess for PAD. The analysis was done using descriptive statistics. RESULTS The mean age was 69.3 ± 7 years comprising 76.5% females, 50% of the respondents were married, while 47% were widowed. The ABI showed 35.4% prevalence of PAD, while TBI for respondents with elevated ABI was 45.0%. CONCLUSION The study showed a point prevalence of PAD to be 37.8%. From the total respondents, 45.7% had mild, while 2.9% had severe PAD. Routine screening for PAD is recommended for the early detection and management.
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Affiliation(s)
- Iboro Samuel Akpan
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Osahon Enabulele
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Afolabi Joseph Adewole
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
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6
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Zeller T, Lopez L, Pigott JP. Acute Outcomes With a Novel Plaque Modification System in Real-World Femoropopliteal Lesions. J Endovasc Ther 2019; 26:333-341. [DOI: 10.1177/1526602819849955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose: To report outcomes of a multicenter feasibility study using the FLEX Vessel Prep (VP) System, a novel technology that facilitates plaque incision and lumen gain in stenosed or occluded femoropopliteal arteries prior to balloon angioplasty. Materials and Methods: Two hundred fifty-five patients (mean age 71.8±9.1 years) were treated with the FLEX VP System at 38 centers between December 2015 and November 2017. Average lesion length was 133±88 mm. Average baseline stenosis was 92%±11%; 112 (44.3%) of 253 patients presented with a chronic total occlusion. Conventional or drug-coated balloon (DCB) angioplasty was performed in all patients after vessel preparation. Vessel measurements were derived from angiograms acquired at baseline, after FLEX passage, and after subsequent ancillary procedures. Logistic regression analyses were performed to identify baseline or procedure variables that predicted the need for provisional stenting. Results: Average percent reduction in vessel stenosis following treatment with the FLEX VP System was 27%±17%. No flow-limiting dissection, vessel perforation, or embolization was observed; 15 (5.9%) patients had minor (type A or B) dissections. Provisional stenting was performed in 49 (19.2%) patients. Average stenosis following angioplasty ± stenting was 9.1%±7.4%; 9 (3.6%) patients had significant residual stenosis ≥30%. Logistic regression analyses found that patients with dissections, longer lesions, and those receiving conventional balloon dilation alone were most likely to undergo stenting. Conclusion: In a real-world patient population with long, complex femoropopliteal lesions, use of the FLEX VP System as vessel preparation for angioplasty improved acute outcomes compared to historical controls. The rate of provisional stenting was low, and no serious vessel complications were observed.
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Affiliation(s)
- Thomas Zeller
- Department of Angiology, Universitäts-Herzzentrum Freiburg–Bad Krozingen, Bad Krozingen, Germany
| | - Louis Lopez
- Allen County Cardiology, Saint Joseph Hospital, Fort Wayne, IN, USA
| | - John P. Pigott
- Jobst Vascular Institute, Promedica Healthcare Systems, Toledo, OH, USA
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7
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Yata T, Sano M, Kayama T, Naruse E, Yamamoto N, Inuzuka K, Saito T, Katahashi K, Yamanaka Y, Uchida T, Niwayama M, Kanayama N, Takeuchi H, Unno N. Utility of a Finger-Mounted Tissue Oximeter with Near-Infrared Spectroscopy to Evaluate Limb Ischemia in Patients with Peripheral Arterial Disease. Ann Vasc Dis 2019; 12:36-43. [PMID: 30931055 PMCID: PMC6434358 DOI: 10.3400/avd.oa.18-00117] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: To investigate whether a finger-mounted tissue oximeter is useful in evaluating limb blood flow in patients with peripheral arterial disease (PAD). Materials and Methods: Seventy-two patients with PAD were included, and the ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), and skin perfusion pressure (SPP) were measured. The regional tissue oxygenation saturation (rSO2) was measured using a finger-mounted tissue oximeter at the ankle, dorsal foot, and each dorsal and plantar toe. Correlations between rSO2 and ABI and between TcPO2 and SPP were analyzed. The patients were divided into three groups: Fontaine IIa (F-IIa), IIb (F-IIb), and III and IV (F-III/IV) groups. The difference in rSO2 between each group was analyzed. Results: Significant correlations were observed between rSO2 and TcPO2 and between rSO2 and SPP. TcPO2 and SPP in the F-III/IV group were significantly lower than those in the F-IIa group. rSO2 in the F-IIb and F-III/IV groups was significantly lower than that in the F-IIa group. Conclusion: The measurement of rSO2 using finger-mounted tissue oximetry is quick, simple, and painless. It can be used on any skin area and is useful to evaluate limb circulation in patients with PAD.
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Affiliation(s)
- Tatsuro Yata
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Masaki Sano
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Takafumi Kayama
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Ena Naruse
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Naoto Yamamoto
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Division of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
| | - Kazunori Inuzuka
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Takaaki Saito
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kazuto Katahashi
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yuta Yamanaka
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Division of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
| | - Toshiyuki Uchida
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Masatsugu Niwayama
- Department of Electrical and Electronic Engineering, Shizuoka University, Hamamatsu, Shizuoka, Japan
| | - Naohiro Kanayama
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hiroya Takeuchi
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Naoki Unno
- Division of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,Division of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
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8
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Takahashi I, Cologne J, Haruta D, Yamada M, Takahashi T, Misumi M, Fujiwara S, Matsumoto M, Kihara Y, Hida A, Ohishi W. Association Between Prevalence of Peripheral Artery Disease and Radiation Exposure in the Atomic Bomb Survivors. J Am Heart Assoc 2018; 7:e008921. [PMID: 30486720 PMCID: PMC6405541 DOI: 10.1161/jaha.118.008921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/25/2018] [Indexed: 12/27/2022]
Abstract
Background Past reports suggested that total-body irradiation at 0.5 to 1.0 Gy could be responsible for atherosclerosis. Peripheral artery disease ( PAD ) is a manifestation of systematic atherosclerosis. Whether the consequences of a low-to-moderate dose of radiation include increased risk of PAD remains to be determined. The purpose of this study was to examine the association between radiation exposure and prevalence of PAD among Japanese atomic bomb survivors. Methods and Results Radiation exposure from the atomic bombing was assessed in 3476 participants (41.1% men, mean age 74.8 years with SD 6.4 years) with a cross-sectional survey in 2010 to 2014. Left- and right-side ankle-brachial indexes and upstroke time ( UT ) were obtained using oscillometric VP -2000. PAD was defined as an ankle-brachial index of 1.0 or less or a prior history related to revascularization. UT was considered a sensitive marker of early-stage PAD . Association between radiation exposure and PAD or UT was assessed using multivariable regression analyses with adjustment for potential confounding factors. Of 3476 participants, 79 (2.3%) were identified as having prevalent PAD . Multivariate logistic regression analysis indicated that radiation dose was unrelated to PAD prevalence (odds ratio, 0.83; 95% confidence interval [0.57-1.21]). UT appeared to increase with radiation dose, but the increase was not statistically significant (1.09 ms/Gy; 95% confidence interval [-0.17 to 2.36]). Conclusions We found no clear association of radiation dose with PAD , but it remains to be determined whether UT is associated with radiation dose.
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Affiliation(s)
- Ikuno Takahashi
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - John Cologne
- Department of StatisticsRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Daisuke Haruta
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)NagasakiJapan
| | - Michiko Yamada
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and TherapeuticsHiroshima UniversityHiroshimaJapan
| | - Munechika Misumi
- Department of StatisticsRadiation Effects Research Foundation (RERF)HiroshimaJapan
| | - Saeko Fujiwara
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
- Hiroshima Atomic‐bomb Casualty CouncilHiroshimaJapan
| | - Masayasu Matsumoto
- Department of Clinical Neuroscience and TherapeuticsHiroshima UniversityHiroshimaJapan
- Japan Community Health care OrganizationHoshigaoka Medical CenterOsakaJapan
| | - Yasuki Kihara
- Department of Cardiovascular MedicineHiroshima UniversityHiroshimaJapan
| | - Ayumi Hida
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)NagasakiJapan
| | - Waka Ohishi
- Department of Clinical StudiesRadiation Effects Research Foundation (RERF)HiroshimaJapan
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9
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Stoner L, Hanson ED, Gram M, Allen JD, Malin SK. Research Toolbox for Peripheral Arterial Disease - Minimally Invasive Assessment of the Vasculature and Skeletal Muscle. Circ J 2018; 82:2462-2469. [PMID: 30058605 DOI: 10.1253/circj.cj-18-0283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In 2010, more than 200 million people were afflicted with peripheral arterial disease (PAD). Because it is atherosclerotic in etiology, it is not surprising that PAD is a leading cause of cardiovascular morbidity. Cardiovascular disease (CVD) risk can be decreased if ambulatory physical function is improved. However, physical function is limited by a mismatch between oxygen supply and demand in the legs, which results in exertional pain, leg weakness, and balance problems. Therefore, a key factor for improving physical function, and decreasing CVD outcomes, is ensuring oxygen supply meets the oxygen demand. The purpose of this review is to highlight and evaluate practical and minimally invasive tools for assessing PAD etiology, with a specific focus on tools suited to studies focusing on improving physical function and CVD outcomes. Specifically, the macrovascular, microvascular, and skeletal muscle pathology of PAD is briefly outlined. Subsequently, the tools for assessing each of these components is discussed, including, where available, the evidence to contextualize these tools to PAD pathology as well as physical function and CVD outcomes. The goal of this review is to guide researchers to the appropriate tools with respect to their methodological design.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Martin Gram
- School of Sport and Exercise, Massey University
| | - Jason D Allen
- Department of Kinesiology, University of Virginia.,Division of Cardiovascular Medicine, University of Virginia
| | - Steven K Malin
- Department of Kinesiology, University of Virginia.,Division of Endocrinology & Metabolism, University of Virginia.,Robert M. Berne Cardiovascular Research Center, University of Virginia
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10
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Huang S, Chen Z, Wu W, Wang M, Wang R, Cui J, Li W, Wang S. MicroRNA-31 promotes arterial smooth muscle cell proliferation and migration by targeting mitofusin-2 in arteriosclerosis obliterans of the lower extremitie. Exp Ther Med 2017; 15:633-640. [PMID: 29403548 PMCID: PMC5780846 DOI: 10.3892/etm.2017.5453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/26/2017] [Indexed: 12/12/2022] Open
Abstract
MicroRNA (miR)-31 serves a key role in various biological processes, including tumor development, angiogenesis and inflammation. Whether miR-31 is involved in the pathological processes of arteriosclerosis obliterans (ASO) remains to be elucidated, as does the mechanism of miR-31 regulation of arterial smooth muscle cells (ASMCs). In the present study, miR-31 expression was detected by reverse transcription-quantitative polymerase chain reaction and in situ hybridization, and was significantly upregulated in human ASO arterial walls compared with normal arterial walls (P<0.001). In addition, miR-31 proliferation was detected by Cell Counting Kit-8 and EdU assays; proliferation was significantly promoted in platelet-derived growth factor (PDGF)-BB-induced human ASMCs (HASMCs) (P<0.001). miR-31 migration was detected by transwell and wound closure assays, and was revealed to be promoted in PDGF-BB-induced HASMCs (P<0.001). Lastly, HASMCs were transfected with miR-31 mimics and inhibitors, and negative controls. A dual-luciferase reporter assay was performed to verify that mitofusin-2 (MFN2) was a direct target of miR-31 and that MFN2 expression was significantly downregulated by miR-31 at a post-transcriptional level in HASMCs as detected by western blotting (P<0.01). These findings suggest that miR-31 is able to promote the proliferation and migration of HASMCs, at least in part, by targeting MFN2. The results of the present study provide novel insight into the underlying mechanisms and roles of miR-31/MFN2 in the pathology of ASO, which may offer a potential therapeutic target for the treatment of ASO.
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Affiliation(s)
- Shuichuan Huang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.,Department of Vascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Zhibo Chen
- Department of Vascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Weibin Wu
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Mian Wang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Rui Wang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Jin Cui
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Wen Li
- Laboratory of General Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Shenming Wang
- Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
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11
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Vitalis A, Lip GYH, Kay M, Vohra RK, Shantsila A. Ethnic differences in the prevalence of peripheral arterial disease: a systematic review and meta-analysis. Expert Rev Cardiovasc Ther 2017; 15:327-338. [DOI: 10.1080/14779072.2017.1305890] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Antonios Vitalis
- Institute of Cardiovascular Sciences, University of Birmingham, City Hospital, Birmingham, UK
- Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Gregory Y. H. Lip
- Institute of Cardiovascular Sciences, University of Birmingham, City Hospital, Birmingham, UK
| | - Mark Kay
- Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Rajiv K. Vohra
- Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
| | - Alena Shantsila
- Institute of Cardiovascular Sciences, University of Birmingham, City Hospital, Birmingham, UK
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12
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Hong Y, Sebastianski M, Makowsky M, Tsuyuki R, McMurtry MS. Administrative data are not sensitive for the detection of peripheral artery disease in the community. Vasc Med 2016; 21:331-6. [PMID: 27114456 DOI: 10.1177/1358863x16631041] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We sought to evaluate whether case ascertainment using administrative health data would be a feasible way to identify peripheral artery disease (PAD) patients from the community. Subjects' ankle-brachial index (ABI) scores from two previous prospective observational studies were linked with International Classification of Diseases (ICD) and Canadian Classification of Interventions (CCI) codes from three administrative databases from April 2002 to March 2012, including the Alberta Inpatient Hospital Database (ICD-10-CA/CCI), Ambulatory Care Database (ICD-10-CA/CCI), and the Practitioner Payments Database (ICD-9-CM). We calculated diagnostic statistics for putative case definitions of PAD consisting of individual code or sets of codes, using an ABI score ⩽ 0.90 as the gold standard. Multivariate logistic regression was performed to investigate additional predictive factors for PAD. Different combinations of diagnostic codes and predictive factors were explored to find out the best algorithms for identifying a PAD study cohort. A total of 1459 patients were included in our analysis. The average age was 63.5 years, 66% were male, and the prevalence of PAD was 8.1%. The highest sensitivity of 34.7% was obtained using the algorithm of at least one ICD diagnostic or procedure code, with specificity 91.9%, positive predictive value (PPV) 27.5% and negative predictive value (NPV) 94.1%. The algorithm achieving the highest PPV of 65% was age ⩾ 70 years and at least one code within 443.9 (ICD-9-CM), I73.9, I79.2 (ICD-10-CA/CCI), or all procedure codes, validated with ABI < 1.0 (sensitivity 5.56%, specificity 99.4% and NPV 84.6%). In conclusion, ascertaining PAD using administrative data scores was insensitive compared with the ABI, limiting the use of administrative data in the community setting.
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Affiliation(s)
- Yongzhe Hong
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Meghan Sebastianski
- Epidemiology Coordinating and Research (EPICORE) Centre, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mark Makowsky
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Ross Tsuyuki
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada Epidemiology Coordinating and Research (EPICORE) Centre, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - M Sean McMurtry
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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13
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Hokimoto S, Soejima H, Kojima S, Kaikita K, Yamamuro M, Izumiya Y, Tsujita K, Yamamoto E, Tanaka T, Sugamura K, Arima Y, Sakamoto K, Akasaka T, Tabata N, Sueta D, Miyoshi I, Usami M, Ogawa H. Distribution of Ankle-Brachial Index among Inpatients with Cardiovascular Disease: Analysis Using the Kumamoto University Hospital Medical Database. Ann Vasc Dis 2016; 9:22-9. [PMID: 27087869 DOI: 10.3400/avd.oa.15-00089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 12/10/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the distribution of ankle-brachial index (ABI) among Japanese cardiovascular inpatients and to explore risk factors of peripheral arterial disease (PAD) associated with ABI ≤0.9. MATERIALS AND METHODS This study was a retrospective analysis using clinical record databases of patients with cardiovascular disease admitted to the Department of Cardiovascular Medicine, Kumamoto University Hospital between 2007 and 2014. RESULTS Of 3639 patients included in the analysis, male patients accounted for 62.1% and the mean age of patients was 66.1 years. Ischemic heart disease (IHD) was observed in 49.1%. ABI ≤0.9 was observed in 11.3% of all patients, 14.1% in the IHD group and 8.5% in the non-IHD group. Age of ≥65 years (odds ratio [OR]: 2.93, 95% confidence interval [CI]: 2.22-3.86), current smoking (OR: 2.28, 95%CI:1.71-3.04), diabetes (OR: 2.15, 95%CI:1.71-2.71), hypertension (OR: 1.42, 95%CI:1.12-1.81) and chronic kidney disease (OR: 2.52, 95%CI:1.82-3.48) were significantly associated factors with ABI ≤0.9. CONCLUSIONS This study suggests that PAD is prevalent even in patients without IHD. Active management of risk factors, early detection of PAD based on ABI, and therapeutic intervention could be effective in preventing future cardiovascular events or death.
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Affiliation(s)
- Seiji Hokimoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Hirofumi Soejima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Sunao Kojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Megumi Yamamuro
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Tomoko Tanaka
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Koichi Sugamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Kenji Sakamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Tomonori Akasaka
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Noriaki Tabata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | | | | | - Hisao Ogawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
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14
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Shimizu M, Furusyo N, Tanaka Y, Kato Y, Mitsumoto-Kaseida F, Takayama K, Ura K, Hiramine S, Hayashi T, Ikezaki H, Ihara T, Mukae H, Ogawa E, Toyoda K, Kainuma M, Murata M, Hayashi J. The relation of postprandial plasma glucose and serum endostatin to the urinary albumin excretion of residents with prediabetes: results from the Kyushu and Okinawa Population Study (KOPS). Int Urol Nephrol 2016; 48:851-7. [PMID: 26984739 DOI: 10.1007/s11255-016-1258-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 02/29/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous clinical studies have shown that the circulating level of endostatin is related to kidney injury. We hypothesized that the impact of HbA1c, fasting, and postprandial plasma glucose on urinary albumin excretion would be related to the serum endostatin level. METHODS A cross-sectional, community-based population study of 1057 Japanese residents was conducted. Of these subjects, 162 with a fasting plasma glucose value between 5.5 and 6.9 mmol/L and an HbA1c level of <6.5 % received an oral glucose tolerance test, had serum endostatin measured, and had the urinary albumin/creatinine ratio (UACR) calculated. RESULTS In multivariate analysis, 2-h postprandial plasma glucose (β = 0.26, P < 0.01) was significantly associated with log-transformed UACR, independently of fasting plasma glucose (β = 0.14, P = 0.28) and HbA1c (β = -0.08, P = 0.57). When divided by the median value of endostatin (82.2 ng/mL), 2-h postprandial plasma glucose (β = 0.38, P = 0.01) remained significantly associated with the log-transformed UACR of the participants below the median, while the fasting plasma glucose (β = 0.34, P = 0.046) was independently associated with the log-transformed UACR of participants above the median. CONCLUSION Postprandial plasma glucose was independently associated with the urinary albumin excretion of the residents with prediabetes. Moreover, this relationship was limited to residents with a serum endostatin level below the median.
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Affiliation(s)
- Motohiro Shimizu
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yuuki Tanaka
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yoshifumi Kato
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Fujiko Mitsumoto-Kaseida
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Koji Takayama
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kazuya Ura
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Satoshi Hiramine
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takeo Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Takeshi Ihara
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Haru Mukae
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Mosaburo Kainuma
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.,Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan
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15
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Sotoda Y, Hirooka S, Orita H, Wakabayashi I. [Recent Knowledge of Smoking and Peripheral Arterial Disease in Lower Extremities]. Nihon Eiseigaku Zasshi 2015; 70:211-9. [PMID: 26411939 DOI: 10.1265/jjh.70.211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Peripheral arterial disease (PAD) is an atherosclerotic obstructive disease of the arteries in lower extremities. Patients with PAD show high rates of mortality from coronary artery disease (CAD) and stroke. Smoking as well as diabetes is an important risk factor for PAD. A lesion of PAD in the lower extremities tends to be more proximal in smokers than in nonsmokers and to be more distal in patients with diabetes than in nondiabetics. By a systematic review, the odds ratio for PAD of smokers vs nonsmokers has been reported to be in the range of 1.7-7.4. Previous epidemiological studies suggest a stronger association of smoking with PAD than that with CAD. Nitric oxide (NO) is an important molecule suppressing the progression of atherosclerosis, but this function is compromised by smoking. Smoking decreases the bioactivity of NO and the expression level of NO synthase. In addition, smoking results in deteriorations of risk factors for atherosclerosis such as decreases in blood HDL (high-density lipoprotein) cholesterol and tissue plasminogen activator levels and increases in the levels of blood triglycerides, LDL (low-density lipoprotein) cholesterol, fibrinogen and the von Willebrand factor. Thus, smoking increases blood coagulability and deteriorates the blood lipid profile, resulting in thrombogenetic proneness and dyslipidemia. Smoking also increases the generation of atherogenic oxidized LDL in blood and decreases antiatherogenic prostacyclin production in the vascular endothelium. Smoking cessation is important for the prevention and therapy of PAD, and to this end, counseling by physicians and nicotine replacement therapy are useful and strongly recommended for patients with PAD.
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Affiliation(s)
- Yoko Sotoda
- Department of Cardiovascular Surgery, Yamagata Saisei Hospital
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16
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Sanada F, Taniyama Y, Kanbara Y, Otsu R, Ikeda-Iwabu Y, Carracedo M, Rakugi H, Morishita R. Gene therapy in peripheral artery disease. Expert Opin Biol Ther 2015; 15:381-90. [PMID: 25633211 DOI: 10.1517/14712598.2015.1007039] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Despite the remarkable progress of medicine and endovascular procedures for revascularization, patients with critical limb ischemia (CLI) remain at high risk for amputation and often have a low quality of life due to pain and ulcers in the ischemic leg. Thus, a novel strategy for generating new blood vessels in CLI patients without treatment options is vital. Pre-clinical studies and Phase I clinical trials using VEGF and fibroblast growth factor (FGF) demonstrated promising results; however, more rigorous Phase II and III clinical trials failed to demonstrate benefits for CLI patients. Recently, two multicenter, double-blind, placebo-controlled clinical trials in Japan (Phase III) and the USA (Phase II) showed the benefits of hepatocyte growth factor (HGF) gene therapy for CLI patients. Although the number of patients included in these trials was relatively small, these results imply a distinct beneficial function for HGF over other angiogenic growth factors in a clinical setting. AREAS COVERED In this review, data from Phase I-III clinical trials of gene therapy for patients with peripheral artery disease (PAD) are examined. In addition, the potential mechanisms behind the success or failure of clinical trials are discussed. EXPERT OPINION Compared with VEGF and FGF, HGF has a unique molecular effect on inflammation, fibrosis and cell senescence under pathological conditions. These features may explain the clinical benefits of HGF in PAD patients.
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Affiliation(s)
- Fumihiro Sanada
- Osaka University Graduate School of Medicine, Department of Clinical Gene Therapy , Suita, Osaka 565-0871 , Japan
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17
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Taniguchi H, Shiba T, Maeno T, Takahashi M. Evaluation of Carotid Atherosclerosis, Peripheral Arterial Disease, and Chronic Kidney Disease in Patients with Exudative Age-Related Macular Degeneration without Coronary Artery Disease or Stroke. Ophthalmologica 2015; 233:128-33. [PMID: 25633305 DOI: 10.1159/000371716] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/17/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the risk factors for acute atherothrombotic events in patients with exudative age-related macular degeneration (AMD) without a history of coronary artery disease or stroke. METHODS Two hundred fifty-nine patents with exudative AMD were evaluated for carotid atherosclerosis, peripheral arterial disease, and chronic kidney disease (CKD). RESULTS A mean intima-media thickness of ≥1.0 mm was found in 28.2% of patients; 8.9% of patients had severe carotid artery stenosis. The prevalence rates of severe atherosclerosis with a plaque score >10, peripheral arterial disease, and CKD were 16.6, 5.4, and 32%, respectively. Diabetes mellitus and AMD affecting eyes bilaterally were identified as risk factors for abnormal carotid artery thickening, and age and body mass index were identified as risk factors for CKD. CONCLUSION The current study confirmed that potentially 30% of patients with exudative AMD without a history of coronary artery disease or stroke have a high risk of acute atherothrombotic events.
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Affiliation(s)
- Hikari Taniguchi
- Department of Ophthalmology, Toho University Sakura Medical Center, Chiba, Japan
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18
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Shimizu M, Furusyo N, Mitsumoto F, Takayama K, Ura K, Hiramine S, Ikezaki H, Ihara T, Mukae H, Ogawa E, Toyoda K, Kainuma M, Murata M, Hayashi J. Subclinical carotid atherosclerosis and triglycerides predict the incidence of chronic kidney disease in the Japanese general population: results from the Kyushu and Okinawa Population Study (KOPS). Atherosclerosis 2014; 238:207-12. [PMID: 25528429 DOI: 10.1016/j.atherosclerosis.2014.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 11/28/2014] [Accepted: 12/02/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine whether or not subclinical atherosclerosis independently predicts the incidence of chronic kidney disease (CKD) in the Japanese general population. METHODS This study is part of the Kyushu and Okinawa Population Study (KOPS), a survey of vascular events associated with lifestyle-related diseases. Participants who attended both baseline (2004-2007) and follow-up (2009-2012) examinations were eligible. The common carotid intima-media thickness (IMT) was assessed for each participant at baseline. The end point was the incidence of CKD, defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) during the follow-up of participants without CKD at baseline. RESULTS During the five-year follow-up, 224 of the 1824 participants (12.3%) who developed CKD had higher carotid IMT (0.74 ± 0.22 vs. 0.65 ± 0.14 mm, P < 0.001), higher triglycerides (1.6 ± 0.8 vs. 1.3 ± 0.7 mmol/L, P < 0.001), and lower high density lipoprotein cholesterol (1.5 ± 0.4 vs. 1.6 ± 0.4 mmol/L, P < 0.001) at baseline than those who did not. In logistic regression analysis adjusted for significant covariates, eGFR (Odds ratio [OR] 0.83, 95% confidence interval (CI) 0.80-0.85, P < 0.001), carotid IMT (0.10 mm increase: OR 1.17, 95% CI 1.04-1.33, P = 0.010), and triglycerides (OR 1.35, 95% CI 1.06-1.73, P = 0.015) at baseline were independent predictors for the development of CKD. CONCLUSIONS Higher carotid IMT and hypertriglyceridemia were independently associated with the development of CKD in the population studied.
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Affiliation(s)
- Motohiro Shimizu
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
| | - Fujiko Mitsumoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Takayama
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kazuya Ura
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Satoshi Hiramine
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takeshi Ihara
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Haru Mukae
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Mosaburo Kainuma
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan; Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan
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19
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He C, Yang JG, Li YM, Rong J, Du FZ, Yang ZG, Gu M. Comparison of lower extremity atherosclerosis in diabetic and non-diabetic patients using multidetector computed tomography. BMC Cardiovasc Disord 2014; 14:125. [PMID: 25252783 PMCID: PMC4182836 DOI: 10.1186/1471-2261-14-125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 09/22/2014] [Indexed: 11/18/2022] Open
Abstract
Background Lower extremity atherosclerosis (LEA) is among the most serious diabetic complications and leads to non-traumatic amputations. The recently developed dual-source CT (DSCT) and 320- multidetector computed tomography (MDCT) may help to detect plaques more precisely. The aim of our study was to evaluate the differences in LEA between diabetic and non-diabetic patients using MDCT angiography. Methods DSCT and 320-MDCT angiographies of the lower extremities were performed in 161 patients (60 diabetic and 101 non-diabetic). The plaque type, distribution, shape and obstructive natures were compared. Results Compared with non-diabetic patients, diabetic patients had higher peripheral neuropathy, history of cerebrovasuclar infarction and hypertension rates. A total of 2898 vascular segments were included in the analysis. Plaque and stenosis were detected in 681 segments in 60 diabetic patients (63.1%) and 854 segments in 101 non-diabetic patients (46.9%; p <0.05). Regarding these plaques, diabetic patients had a higher incidence of mixed plaques (34.2% vs. 27.1% for non-diabetic patients). An increased moderate stenosis rate and decreased occlusion rate were observed in diabetic patients relative to non-diabetic patients (35.8% vs. 28.3%; and 6.6% vs. 11.4%; respectively). In diabetic patients, 362 (53.2%) plaques were detected in the distal lower leg segments, whereas in non-diabetic patients, 551 (64.5%) plaques were found in the proximal upper leg segments. The type IV plaque shape, in which the full lumen was involved, was detected more frequently in diabetic patients than in non-diabetic patients (13.1% vs. 8.2%). Conclusion Diabetes is associated with a higher incidence of plaque, increased incidence of mixed plaques, moderate stenosis and localisation primarily in the distal lower leg segments. The advanced and non-invasive MDCT could be used for routine preoperative evaluations of LEA.
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Affiliation(s)
| | | | | | | | | | | | - Ming Gu
- Department of Radiology, Chengdu Military General Hospital, Chengdu, Sichuan 610083, China.
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Gautam M, Izawa A, Shiba Y, Motoki H, Takeuchi T, Okada A, Tomita T, Miyashita Y, Koyama J, Ikeda U. Importance of fatty acid compositions in patients with peripheral arterial disease. PLoS One 2014; 9:e107003. [PMID: 25191963 PMCID: PMC4156400 DOI: 10.1371/journal.pone.0107003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 08/04/2014] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Importance of fatty acid components and imbalances has emerged in coronary heart disease. In this study, we analyzed fatty acids and ankle-brachial index (ABI) in a Japanese cohort. METHODS Peripheral arterial disease (PAD) was diagnosed in 101 patients by ABI ≤0.90 and/or by angiography. Traditional cardiovascular risk factors and components of serum fatty acids were examined in all patients (mean age 73.2±0.9 years; 81 males), and compared with those in 373 age- and sex-matched control subjects with no evidence of PAD. RESULTS The presence of PAD (mean ABI: 0.71±0.02) was independently associated with low levels of gamma-linolenic acid (GLA) (OR: 0.90; 95% CI: 0.85-0.96; P = 0.002), eicosapentaenoic acid∶arachidonic acid (EPA∶AA) ratio (OR: 0.38; 95% CI: 0.17-0.86; P = 0.021), and estimated glomerular filtration rate (OR: 0.97; 95% CI: 0.96-0.98; P<0.0001), and with a high hemoglobin A1c level (OR: 1.34; 95% CI: 1.06-1.69; P = 0.013). Individuals with lower levels of GLA (≤7.95 µg/mL) and a lower EPA∶AA ratio (≤0.55) had the lowest ABI (0.96±0.02, N = 90), while the highest ABI (1.12±0.01, N = 78) was observed in individuals with higher values of both GLA and EPA∶AA ratio (P<0.0001). CONCLUSION A low level of GLA and a low EPA∶AA ratio are independently associated with the presence of PAD. Specific fatty acid abnormalities and imbalances could lead to new strategies for risk stratification and prevention in PAD patients.
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Affiliation(s)
- Milan Gautam
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Atsushi Izawa
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
- * E-mail:
| | - Yuji Shiba
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hirohiko Motoki
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Takahiro Takeuchi
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Ayako Okada
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Takeshi Tomita
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yusuke Miyashita
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Jun Koyama
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Uichi Ikeda
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Hosaka A, Miyata T, Onishi Y, Liao L, Zhang Q. Clinical and economic burden in patients with diagnosis of peripheral arterial disease in a claims database in Japan. Clin Ther 2014; 36:1223-30, 1230.e1-4. [PMID: 25012730 DOI: 10.1016/j.clinthera.2014.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 04/26/2014] [Accepted: 06/09/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE The effect of peripheral arterial disease (PAD) among young and middle-aged adults can be significant, but no previous study has examined the prognosis and the associated health care cost of the disease in this population. We evaluated the clinical and economic burden of PAD in patients from a large claims database to clarify the effect of the disease on a relatively young working Japanese population. METHODS Patients aged ≥45 and ≤64 years with first PAD diagnosis between 2005 and 2011 comprised the PAD cohort (n = 362); an age- and sex-matched non-PAD comparison cohort (n = 362) was also identified. Rates of cardiovascular events/interventions, health care utilization, and costs were compared. FINDINGS The mean (SD) age of the cohort was 52.8 (5.6) years and 40.8% were women. Baseline Charlson comorbidity index was significantly higher in the PAD cohort than in the non-PAD cohort (1.90 [2.19] vs 1.16 [1.99]; P < 0.001). The PAD cohort had significantly higher first-year event rates than did the non-PAD cohort for myocardial infarction (2.2% vs 0.2%; P = 0.019) and ischemic stroke (4.1% vs 0.5%; P = 0.001). Health care utilization was significantly greater for the PAD cohort for all parameters assessed (number of hospitalization, inpatient days, and outpatient visits) in the first year (all, P < 0.001). Total annual costs for health care were significantly higher in the PAD cohort than in the non-PAD cohort in the first year (P < 0.001). Among patients with diabetes, patients with PAD (n = 98) had significantly greater first-year event rates (myocardial infarction, ischemic stroke, coronary artery bypass surgery, peripheral arterial revascularization, percutaneous coronary intervention, and limb amputation; all, P < 0.001), significantly greater number of clinic visits (P = 0.023), and total cost burden than did patients without PAD (n = 63). IMPLICATIONS Even in a relatively young working Japanese population, PAD is associated with substantial clinical and economic burden.
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Affiliation(s)
- Akihiro Hosaka
- Department of Surgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
| | - Tetsuro Miyata
- Vascular Center, Sanno Hospital and Sanno Medical Center, Tokyo, Japan
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Fowkes FGR, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott MM, Norman PE, Sampson UKA, Williams LJ, Mensah GA, Criqui MH. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 2013; 382:1329-40. [PMID: 23915883 DOI: 10.1016/s0140-6736(13)61249-0] [Citation(s) in RCA: 2239] [Impact Index Per Article: 203.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Lower extremity peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity, following coronary artery disease and stroke. This study provides the first comparison of the prevalence of peripheral artery disease between high-income countries (HIC) and low-income or middle-income countries (LMIC), establishes the primary risk factors for peripheral artery disease in these settings, and estimates the number of people living with peripheral artery disease regionally and globally. METHODS We did a systematic review of the literature on the prevalence of peripheral artery disease in which we searched for community-based studies since 1997 that defined peripheral artery disease as an ankle brachial index (ABI) lower than or equal to 0·90. We used epidemiological modelling to define age-specific and sex-specific prevalence rates in HIC and in LMIC and combined them with UN population numbers for 2000 and 2010 to estimate the global prevalence of peripheral artery disease. Within a subset of studies, we did meta-analyses of odds ratios (ORs) associated with 15 putative risk factors for peripheral artery disease to estimate their effect size in HIC and LMIC. We then used the risk factors to predict peripheral artery disease numbers in eight WHO regions (three HIC and five LMIC). FINDINGS 34 studies satisfied the inclusion criteria, 22 from HIC and 12 from LMIC, including 112,027 participants, of which 9347 had peripheral artery disease. Sex-specific prevalence rates increased with age and were broadly similar in HIC and LMIC and in men and women. The prevalence in HIC at age 45-49 years was 5·28% (95% CI 3·38-8·17%) in women and 5·41% (3·41-8·49%) in men, and at age 85-89 years, it was 18·38% (11·16-28·76%) in women and 18·83% (12·03-28·25%) in men. Prevalence in men was lower in LMIC than in HIC (2·89% [2·04-4·07%] at 45-49 years and 14·94% [9·58-22·56%] at 85-89 years). In LMIC, rates were higher in women than in men, especially at younger ages (6·31% [4·86-8·15%] of women aged 45-49 years). Smoking was an important risk factor in both HIC and LMIC, with meta-OR for current smoking of 2·72 (95% CI 2·39-3·09) in HIC and 1·42 (1·25-1·62) in LMIC, followed by diabetes (1·88 [1·66-2·14] vs 1·47 [1·29-1·68]), hypertension (1·55 [1·42-1·71] vs 1·36 [1·24-1·50]), and hypercholesterolaemia (1·19 [1·07-1·33] vs 1·14 [1·03-1·25]). Globally, 202 million people were living with peripheral artery disease in 2010, 69·7% of them in LMIC, including 54·8 million in southeast Asia and 45·9 million in the western Pacific Region. During the preceding decade the number of individuals with peripheral artery disease increased by 28·7% in LMIC and 13·1% in HIC. INTERPRETATION In the 21st century, peripheral artery disease has become a global problem. Governments, non-governmental organisations, and the private sector in LMIC need to address the social and economic consequences, and assess the best strategies for optimum treatment and prevention of this disease. FUNDING Peripheral Arterial Disease Research Coalition (Europe).
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Affiliation(s)
- F Gerald R Fowkes
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
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Furusyo N, Koga T, Ai M, Otokozawa S, Kohzuma T, Ikezaki H, Schaefer EJ, Hayashi J. Plasma glycated albumin level and atherosclerosis: Results from the Kyushu and Okinawa Population Study (KOPS). Int J Cardiol 2013; 167:2066-72. [DOI: 10.1016/j.ijcard.2012.05.045] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 04/19/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022]
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Ihara T, Furusyo N, Hayashi T, Toyoda K, Murata M, Hayashi J. A population-based epidemiological survey of human parvovirus B19 infection: a project of the Kyushu and Okinawa Population Study (KOPS). Arch Virol 2013; 158:2465-72. [DOI: 10.1007/s00705-013-1746-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/24/2013] [Indexed: 10/26/2022]
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Kumakura H, Kanai H, Araki Y, Hojo Y, Kasama S, Sumino H, Iwasaki T, Takayama Y, Ichikawa S, Fujita K, Nakashima K, Minami K. Differences in Brain Natriuretic Peptide and Other Factors between Japanese Peripheral Arterial Disease Patients with Critical Limb Ischemia and Intermittent Claudication. J Atheroscler Thromb 2013; 20:798-806. [DOI: 10.5551/jat.18929] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Zhan Y, Yu J, Chen R, Sun Y, Fu Y, Zhang L, Li S, Zhang F, Hu D. Prevalence of low ankle brachial index and its association with pulse pressure in an elderly Chinese population: a cross-sectional study. J Epidemiol 2012; 22:454-61. [PMID: 22813646 PMCID: PMC3798641 DOI: 10.2188/jea.je20110140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background We investigated the prevalence of low ankle brachial index (ABI) and the association of low ABI with pulse pressure among elderly community residents in China. Methods This population-based cross-sectional study was conducted in Beijing and recruited 2982 participants who were aged 60 years or older in 2007. Low ABI was defined as an ABI value less than 0.9 in either leg. Participants with or without stroke or coronary heart disease (CHD) were analyzed separately. The association between pulse pressure and low ABI was examined by using multiple logistic regression models. Results The prevalence of low ABI was 5.65% (4.24% among men and 6.52% among women; P = 0.0221) among participants without stroke or CHD and 10.91% (13.07% among men and 9.49% among women; P = 0.1328) among those with stroke or CHD. After adjusting for confounders, the odds ratio (95% CI) for each 5-mm Hg increase in pulse pressure was 1.19 (1.07, 1.33) and 1.10 (1.02, 1.20) for men and women, respectively, among participants without stroke or CHD and 1.17 (1.03, 1.34) and 1.15 (1.02, 1.30) for men and women with stroke or CHD. When pulse pressure was classified into quartiles and the lowest quartile was used as reference, the association between pulse pressure and low ABI remained positive in men and women. Conclusions Low ABI was prevalent among elderly Chinese, and pulse pressure was positively associated with low ABI.
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Affiliation(s)
- Yiqiang Zhan
- Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety (Ministry of Education), School of Public Health, Fudan University, Shanghai, PR China
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Kabul HK, Aydogdu A, Tasci I. Calculation methods of ankle brachial index and correct diagnosis of peripheral arterial disease. J Atheroscler Thromb 2012; 19:691-2. [PMID: 22504290 DOI: 10.5551/jat.12922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Toyoda K, Furusyo N, Ihara T, Ikezaki H, Urita Y, Hayashi J. Serum pepsinogen and Helicobacter pylori infection--a Japanese population study. Eur J Clin Microbiol Infect Dis 2012; 31:2117-24. [PMID: 22354521 DOI: 10.1007/s10096-011-1543-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 12/29/2011] [Indexed: 12/11/2022]
Abstract
The decreased ratio of serum pepsinogen (PG) I and II has good correlation with the presence of atrophic gastritis. A total of 1,540 residents aged 30-89 years were enrolled into this study to investigate which serum PG level of residents with Helicobacter pylori infection would represent an adjunct to the diagnosis and progression of atrophic gastritis. All participants received esophagogastroduodenoscopy. Serum antibody to H. pylori (anti-H. pylori) was measured by an enzyme-linked immunosorbent assay (ELISA). Serological atrophic gastritis was defined as serum PG I isozyme level ≤70 ng/ml and a PG I/II ratio of ≤3.0. Of the 1,540 participants, 923 (59.9%) were positive for anti-H. pylori. Serological atrophic gastritis was found significantly more often in anti-H. pylori-positive participants (40.8%) than in anti-H. pylori-negative participants (7.9%) (p ≤ 0.0001). The endoscopic findings of anti-H. pylori-positive participants with serological atrophic gastritis were significantly more frequent by 4.06 times for atrophic gastritis (p ≤ 0.0001) than anti-H. pylori-negative participants without serological atrophic gastritis. Eight anti-H. pylori-positive participants were diagnosed with gastric cancer, but no cancer was found in anti-H. pylori-negative participants without serological atrophic gastritis. Serum PG testing is clinically useful for the prediction of gastric lesions in H. pylori-infected persons.
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Affiliation(s)
- K Toyoda
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
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Unno M, Furusyo N, Mukae H, Koga T, Eiraku K, Hayashi J. The utility of visceral fat level by bioelectrical impedance analysis in the screening of metabolic syndrome - the results of the Kyushu and Okinawa Population Study (KOPS). J Atheroscler Thromb 2012; 19:462-70. [PMID: 22659530 DOI: 10.5551/jat.11528] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM A simple, non-invasive medical device, using bioelectrical impedance analysis (BIA) for the evaluation of visceral fat level (VFL) was developed recently. The aim of this study was to investigate the utility of VFL by BIA in the screening of metabolic syndrome (MetS). METHODS VFL was measured by the BIA device in 1,451 Japanese residents (546 men and 905 women, age range 30-69 years). RESULTS VFL had significant positive correlations with waist circumference (WC) and body mass index (r=0.772 and 0.849, all P < 0.0001). The overall MetS prevalence using Japanese Diagnosis Criteria was 19.8%: men 36.3% and women 9.8%. The mean VFL of the participants with MetS was significantly higher than those without MetS (men; 12.1 and 9.4, women; 13.3 and 8.7) (both P < 0.001). VFL significantly correlated with blood pressure, lipid profiles, fasting plasma glucose, and hemoglobin A1c (all P < 0.001). Receiver operating characteristic curve analysis for a diagnosis of two or more MetS risk factors excluding WC resulted in the same cutoff values for the VFL (10.0) of men and women. CONCLUSIONS The VFL by BIA is useful for the detection of MetS because it is correlated with all metabolic parameters and shows the same normal limit in both sexes.
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Affiliation(s)
- Mami Unno
- Department of Environmental Medicine and Infectious Diseases, Kyushu University, Fukuoka, Japan
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Catena C, Colussi G, Brosolo G, Sechi LA. A Prothrombotic State is Associated with Early Arterial Damage in Hypertensive Patients. J Atheroscler Thromb 2012; 19:471-8. [DOI: 10.5551/jat.10819] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Cristiana Catena
- Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medicine, University of Udine
| | - GianLuca Colussi
- Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medicine, University of Udine
| | - Gabriele Brosolo
- Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medicine, University of Udine
| | - Leonardo A Sechi
- Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medicine, University of Udine
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Sex-related differences in Japanese patients with peripheral arterial disease. Atherosclerosis 2011; 219:846-50. [DOI: 10.1016/j.atherosclerosis.2011.08.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/13/2011] [Accepted: 08/21/2011] [Indexed: 11/18/2022]
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Furusyo N, Koga T, Ai M, Otokozawa S, Kohzuma T, Ikezaki H, Schaefer EJ, Hayashi J. Utility of glycated albumin for the diagnosis of diabetes mellitus in a Japanese population study: results from the Kyushu and Okinawa Population Study (KOPS). Diabetologia 2011; 54:3028-36. [PMID: 21947435 DOI: 10.1007/s00125-011-2310-6] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 08/24/2011] [Indexed: 12/27/2022]
Abstract
AIMS/HYPOTHESIS Glycated albumin is a measure of the mean plasma glucose concentration over approximately 2-3 weeks. We determined reference values for glycated albumin, and assessed its utility for the diagnosis of type 2 diabetes mellitus in the general population. METHODS We studied 1,575 men and women (mean age, 49.9 years; range, 26-78 years) who participated in a periodic health examination in a suburban Japanese town. HbA(1c) and fasting plasma concentrations of glucose (FPG) and glycated albumin were measured. Participants with FPG ≥ 7.0 mmol/l or HbA(1c) ≥ 6.5% (48 mmol/mol) were diagnosed as having diabetes. In our laboratory, the glycated albumin assay had intra-assay and inter-assay CVs of 1.1% and 1.6%, respectively. RESULTS Glycated albumin levels were significantly correlated with HbA(1c) levels (r = 0.766, p < 0.001) and FPG (r = 0.706, p < 0.001). The presence of diabetes was significantly higher in participants with glycated albumin levels between 15.0% and 15.9% (five of 276, 1.81%) than in those with glycated albumin <14% (three of 672, 0.45%) (p = 0.037), and was markedly increased in those with a glycated albumin level >16% (58 of 207, 28.0%). Receiver operating characteristic curve analysis indicated that a glycated albumin level of ≥15.5% was optimal for predicting diabetes, with a sensitivity of 83.3% and a specificity of 83.3%. CONCLUSIONS/INTERPRETATION There is merit to further investigating the potential for glycated albumin to be used as an alternative measure of dysglycaemia for future research and clinical practice.
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Affiliation(s)
- N Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan.
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Takahara M, Kaneto H, Iida O, Katakami N, Sakamoto F, Matsuoka TA, Ikeda M, Shimomura I. No Association of Diabetic Duration or Insulin Use with the Prognosis of Critical Limb Ischemia after Endovascular Therapy. J Atheroscler Thromb 2011; 18:1102-9. [DOI: 10.5551/jat.9951] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Peters SA, Dogan S, Meijer R, Palmer MK, Grobbee DE, Crouse JR, O'Leary DH, Evans GW, Raichlen JS, Bots ML. The Use of Plaque Score Measurements to Assess Changes in Atherosclerotic Plaque Burden Induced by Lipid-Lowering Therapy Over Time: The METEOR Study. J Atheroscler Thromb 2011; 18:784-95. [DOI: 10.5551/jat.8169] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Nitta A, Hozawa A, Kuriyama S, Nakaya N, Ohmori-Matsuda K, Sone T, Kakizaki M, Ebihara S, Ichiki M, Arai H, Tsuji I. Relationship between peripheral arterial disease and incident disability among elderly Japanese: the Tsurugaya project. J Atheroscler Thromb 2010; 17:1290-6. [PMID: 21071882 DOI: 10.5551/jat.5389] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The aim of this study was to investigate whether peripheral arterial disease (PAD) is predictive of disability and whether the relationship between PAD and disability can be fully explained by baseline physical functions. METHODS We followed for five years 783 Japanese aged 70 years or older without a disability at baseline in 2003. We defined participants certificed as requiring long-term care as having incident disability. The hazard ratio (HR) and 95% confidence interval (95% CI) for incident disability were calculated using the Cox proportional hazards model. RESULTS After adjusting for possible confounders other than physical function, the HR of incident disability among participants with PAD was 1.86 (95%CI: 1.06 to 3.26).Although the risk was attenuated (HR=1.63, 95%CI: 0.92 to 2.86) after adding baseline physical function as a covariate, the HR was still high. Furthermore, the relation was not statistically significant, but the group with higher physical function and PAD also had a higher HR of incident disability than those who had higher physical function without PAD. CONCLUSION PAD is an important predictor of disability even if the level of baseline physical function is high.
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Affiliation(s)
- Akemi Nitta
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan.
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