Associations between Coffee, #Tea, and Caffeine Intake with Coronary #Artery Calcification and Cardiovascular Events
http://www.amjmed.com/article/S0002-9343(16)30925-1/abstract
Moderate tea drinkers had slower progression of coronary artery calcium and reduced risk for cardiovascular events. Future research is needed to understand the potentially protective nature of moderate tea intake.
http://www.amjmed.com/article/S0002-9343(16)30925-1/abstract
Moderate tea drinkers had slower progression of coronary artery calcium and reduced risk for cardiovascular events. Future research is needed to understand the potentially protective nature of moderate tea intake.
#Ticagrelor versus Clopidogrel in Symptomatic Peripheral #Artery Disease
http://www.nejm.org/doi/full/10.1056/NEJMoa1611688?query=featured_home#abstract
In patients with symptomatic peripheral artery disease, ticagrelor was not shown to be superior to clopidogrel for the reduction of cardiovascular events. Major bleeding occurred at similar rates among the patients in the two trial groups.
http://www.nejm.org/doi/full/10.1056/NEJMoa1611688?query=featured_home#abstract
In patients with symptomatic peripheral artery disease, ticagrelor was not shown to be superior to clopidogrel for the reduction of cardiovascular events. Major bleeding occurred at similar rates among the patients in the two trial groups.
New England Journal of Medicine
Ticagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease — NEJM
Original Article from The New England Journal of Medicine — Ticagrelor versus Clopidogrel in Symptomatic Peripheral Artery Disease
#Stretching may reduce walking pain among peripheral #artery disease patients
http://professional.heart.org/professional/EducationMeetings/MeetingsLiveCME/ATVBPVD/UCM316902ATVBPVD-Scientific-Sessions.jsp
Compared to a month of not stretching, after one month of daily calf stretches the participants:
improved the ability of their calf arteries to relax and expand to let blood flow through after being momentarily held back with a blood pressure cuff (a test called flow-mediated dilation), from an average of 3.7 percent to 5.2 percent - moving them into the normal range for healthy elderly people;
extended how far they could walk in six minutes - about half a city block farther but still well below normal for people the same age; and
prolonged the distance they could walk before needing to stop and rest due to leg discomfort.
http://professional.heart.org/professional/EducationMeetings/MeetingsLiveCME/ATVBPVD/UCM316902ATVBPVD-Scientific-Sessions.jsp
Compared to a month of not stretching, after one month of daily calf stretches the participants:
improved the ability of their calf arteries to relax and expand to let blood flow through after being momentarily held back with a blood pressure cuff (a test called flow-mediated dilation), from an average of 3.7 percent to 5.2 percent - moving them into the normal range for healthy elderly people;
extended how far they could walk in six minutes - about half a city block farther but still well below normal for people the same age; and
prolonged the distance they could walk before needing to stop and rest due to leg discomfort.
Measures of chronic #kidney disease and risk of incident peripheral #artery disease: a collaborative meta-analysis of individual participant data
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30183-3/abstract
Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate eGFR and albuminuria) with the incidence of peripheral artery disease Compared with an eGFR of 95 mL/min per 1·73 m2, adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14–1·30) at an eGFR of 45 mL/min per 1·73 m2 and 2·06 (1·70–2·48) at an eGFR of 15 mL/min per 1·73 m2. Compared with an ACR of 5 mg/g, the adjusted HR for incident study-specific peripheral artery disease was 1·50 (1·41–1·59) at an ACR of 30 mg/g and 2·28 (2·12–2·44) at an ACR of 300 mg/g. The adjusted HR at an ACR of 300 mg/g versus 5 mg/g was 3·68 (95% CI 3·00–4·52) for leg amputation. eGFR and albuminuria contributed multiplicatively (eg, adjusted HR 5·76 4·90–6·77 for incident peripheral artery disease and 10·61 5·70–19·77 for amputation in eGFR <30 mL/min per 1·73 m2 plus ACR ≥300 mg/g or dipstick proteinuria 2+ or higher vs eGFR ≥90 mL/min per 1·73 m2 plus ACR <10 mg/g or dipstick proteinuria negative).
Even mild-to-moderate chronic kidney disease conferred increased risk of incident peripheral artery disease, with a strong association between albuminuria and amputation. Clinical attention should be paid to the development of peripheral artery disease symptoms and signs in people with any stage of chronic kidney disease.
http://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30183-3/abstract
Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate eGFR and albuminuria) with the incidence of peripheral artery disease Compared with an eGFR of 95 mL/min per 1·73 m2, adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14–1·30) at an eGFR of 45 mL/min per 1·73 m2 and 2·06 (1·70–2·48) at an eGFR of 15 mL/min per 1·73 m2. Compared with an ACR of 5 mg/g, the adjusted HR for incident study-specific peripheral artery disease was 1·50 (1·41–1·59) at an ACR of 30 mg/g and 2·28 (2·12–2·44) at an ACR of 300 mg/g. The adjusted HR at an ACR of 300 mg/g versus 5 mg/g was 3·68 (95% CI 3·00–4·52) for leg amputation. eGFR and albuminuria contributed multiplicatively (eg, adjusted HR 5·76 4·90–6·77 for incident peripheral artery disease and 10·61 5·70–19·77 for amputation in eGFR <30 mL/min per 1·73 m2 plus ACR ≥300 mg/g or dipstick proteinuria 2+ or higher vs eGFR ≥90 mL/min per 1·73 m2 plus ACR <10 mg/g or dipstick proteinuria negative).
Even mild-to-moderate chronic kidney disease conferred increased risk of incident peripheral artery disease, with a strong association between albuminuria and amputation. Clinical attention should be paid to the development of peripheral artery disease symptoms and signs in people with any stage of chronic kidney disease.
Association of #Varicose Veins With Incident Venous #Thromboembolism and Peripheral #Artery Disease
https://jamanetwork.com/journals/jama/article-abstract/2673551?redirect=true
The median follow-up duration was 7.5 years for DVT, 7.8 years for PE, and 7.3 years for PAD for patients with varicose veins, and for the control group, follow-up duration was 7.6 years for DVT, 7.7 years for PE, and 7.4 years for PAD. The varicose veins group had higher incidence rates than the control group for DVT (6.55 vs 1.23 per 1000 person-years 10 360 vs 1980 cases; absolute risk difference ARD, 5.32 95% CI, 5.18-5.46), for PE (0.48 for the varicose veins group vs 0.28 for the control group per 1000 person-years 793 vs 451 cases; ARD, 0.20 95% CI, 0.16-0.24), and for PAD (10.73 for the varicose veins group vs 6.22 for the control group per 1000 person-years 16 615 vs 9709 cases; ARD, 4.51 95% CI, 4.31-4.71). The hazard ratios for the varicose veins group compared with the control group were 5.30 (95% CI, 5.05-5.56) for DVT, 1.73 (95% CI, 1.54-1.94) for PE, and 1.72 (95% CI, 1.68-1.77) for PAD.
Conclusions and Relevance Among adults diagnosed with varicose veins, there was a significantly increased risk of incident DVT; the findings for PE and PAD are less clear due to the potential for confounding. Whether the association between varicose veins and DVT is causal or represents a common set of risk factors requires further research
https://jamanetwork.com/journals/jama/article-abstract/2673551?redirect=true
The median follow-up duration was 7.5 years for DVT, 7.8 years for PE, and 7.3 years for PAD for patients with varicose veins, and for the control group, follow-up duration was 7.6 years for DVT, 7.7 years for PE, and 7.4 years for PAD. The varicose veins group had higher incidence rates than the control group for DVT (6.55 vs 1.23 per 1000 person-years 10 360 vs 1980 cases; absolute risk difference ARD, 5.32 95% CI, 5.18-5.46), for PE (0.48 for the varicose veins group vs 0.28 for the control group per 1000 person-years 793 vs 451 cases; ARD, 0.20 95% CI, 0.16-0.24), and for PAD (10.73 for the varicose veins group vs 6.22 for the control group per 1000 person-years 16 615 vs 9709 cases; ARD, 4.51 95% CI, 4.31-4.71). The hazard ratios for the varicose veins group compared with the control group were 5.30 (95% CI, 5.05-5.56) for DVT, 1.73 (95% CI, 1.54-1.94) for PE, and 1.72 (95% CI, 1.68-1.77) for PAD.
Conclusions and Relevance Among adults diagnosed with varicose veins, there was a significantly increased risk of incident DVT; the findings for PE and PAD are less clear due to the potential for confounding. Whether the association between varicose veins and DVT is causal or represents a common set of risk factors requires further research
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Association between #periodontitis and peripheral #artery disease: a systematic review and meta-analysis
https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-018-0879-0
Seven studies including a total of 4307 participants were included in the meta-analysis. The pooled analysis showed that there was a significant difference in the risk of periodontitis between PAD patients and non-PAD participants (RR = 1.70, 95% CI = 1.25–2.29, P = 0.01). There was also a significant difference in number of missing teeth between PAD patients and non-PAD participants (WMD = 3.75, 95% CI = 1.31–6.19, P = 0.003). No significant difference was found in clinical attachment loss between PAD patients and non-PAD participants (WMD = − 0.05, 95% CI = − 0.03–0.19, P = 0.686).
Conclusion
In conclusion, the results of this meta-analysis revealed a significant relationship between periodontitis and PAD. Moreover, our study indicated that PAD patients had more missing teeth than control subjects did. Further high-quality and well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusions of this study.
Association between #periodontitis and peripheral #artery disease: a systematic review and meta-analysis
https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-018-0879-0
Seven studies including a total of 4307 participants were included in the meta-analysis. The pooled analysis showed that there was a significant difference in the risk of periodontitis between PAD patients and non-PAD participants (RR = 1.70, 95% CI = 1.25–2.29, P = 0.01). There was also a significant difference in number of missing teeth between PAD patients and non-PAD participants (WMD = 3.75, 95% CI = 1.31–6.19, P = 0.003). No significant difference was found in clinical attachment loss between PAD patients and non-PAD participants (WMD = − 0.05, 95% CI = − 0.03–0.19, P = 0.686).
Conclusion
In conclusion, the results of this meta-analysis revealed a significant relationship between periodontitis and PAD. Moreover, our study indicated that PAD patients had more missing teeth than control subjects did. Further high-quality and well-designed studies with specific inclusion and exclusion criteria are required to strengthen the conclusions of this study.
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Cohort Study Examining the Association Between Blood #Pressure and Cardiovascular Events in Patients With Peripheral #Artery Disease
https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010748
Adjusted Cox proportional hazards analyses suggested that patients with SBP ≤120 mm Hg were at greater risk of having a major cardiovascular event (myocardial infarction, stroke, or cardiovascular death) than patients with SBP of 121–140 mm Hg (adjusted hazard ratio, 1.36; 95% CI, 1.08–1.72; P=0.009). Patients with SBP >140 mm Hg had an adjusted hazard ratio of 1.23 (95% CI, 1.00–1.51; P=0.051) of major cardiovascular events compared with patients with SBP of 121–140 mm Hg. These findings were similar in sensitivity analyses only including patients receiving antihypertensive medications or focused on patients with a minimum of 3 months of follow‐up.
Conclusions
This cohort study suggests that patients with peripheral artery disease and SBP ≤120 mm Hg are at increased risk of major cardiovascular events. The findings suggest caution in intensive SBP lowering in this patient group.
Cohort Study Examining the Association Between Blood #Pressure and Cardiovascular Events in Patients With Peripheral #Artery Disease
https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010748
Adjusted Cox proportional hazards analyses suggested that patients with SBP ≤120 mm Hg were at greater risk of having a major cardiovascular event (myocardial infarction, stroke, or cardiovascular death) than patients with SBP of 121–140 mm Hg (adjusted hazard ratio, 1.36; 95% CI, 1.08–1.72; P=0.009). Patients with SBP >140 mm Hg had an adjusted hazard ratio of 1.23 (95% CI, 1.00–1.51; P=0.051) of major cardiovascular events compared with patients with SBP of 121–140 mm Hg. These findings were similar in sensitivity analyses only including patients receiving antihypertensive medications or focused on patients with a minimum of 3 months of follow‐up.
Conclusions
This cohort study suggests that patients with peripheral artery disease and SBP ≤120 mm Hg are at increased risk of major cardiovascular events. The findings suggest caution in intensive SBP lowering in this patient group.
MEANINGFUL CHANGE IN SIX-MINUTE #WALK IN PEOPLE WITH PERIPHERAL #ARTERY DISEASE
https://2medical.news/2020/04/29/meaningful-change-in-six-minute-walk-in-people-with-peripheral-artery-disease/
Six-minute walk is a common outcome in clinical trials of people with lower extremity peripheral artery disease (PAD). However, meaningful change in six-minute walk distance is not well defined in people with PAD.. ..777 participants with PAD (mean age: 71.2 years (standard deviation (SD)=8.8) mean baseline six-minute walk: 350.1 meters (SD=118.1) completed 5,439 questions about difficulty walking each WIQ distance at baseline and follow-up. Participants …
https://2medical.news/2020/04/29/meaningful-change-in-six-minute-walk-in-people-with-peripheral-artery-disease/
Six-minute walk is a common outcome in clinical trials of people with lower extremity peripheral artery disease (PAD). However, meaningful change in six-minute walk distance is not well defined in people with PAD.. ..777 participants with PAD (mean age: 71.2 years (standard deviation (SD)=8.8) mean baseline six-minute walk: 350.1 meters (SD=118.1) completed 5,439 questions about difficulty walking each WIQ distance at baseline and follow-up. Participants …
Effect of Cerebrovascular and/or Peripheral #Artery Disease With or Without Attainment of #Lipid Goals on Long-term Outcomes in Patients With Coronary Artery Disease
https://2medical.news/2020/05/18/effect-of-cerebrovascular-and-or-peripheral-artery-disease-with-or-without-attainment-of-lipid-goals-on-long-term-outcomes-in-patients-with-coronary-artery-disease/
Involvement of atherosclerosis in extracardiac vascular territories may identify coronary artery disease (CAD) patients at higher risk for adverse events. We investigated the long-term prognostic implications of polyvascular disease in patients with CAD, and further analyzed lipid goal attainment and its relation to patient outcomes. The study was a retrospective analysis of 10,297 patients undergoing coronary revascularization, categorized as having CAD alone (83.1%) or with …
https://2medical.news/2020/05/18/effect-of-cerebrovascular-and-or-peripheral-artery-disease-with-or-without-attainment-of-lipid-goals-on-long-term-outcomes-in-patients-with-coronary-artery-disease/
Involvement of atherosclerosis in extracardiac vascular territories may identify coronary artery disease (CAD) patients at higher risk for adverse events. We investigated the long-term prognostic implications of polyvascular disease in patients with CAD, and further analyzed lipid goal attainment and its relation to patient outcomes. The study was a retrospective analysis of 10,297 patients undergoing coronary revascularization, categorized as having CAD alone (83.1%) or with …
Screening for Asymptomatic #Carotid #Artery Stenosis Lack of Clinical Benefit, Potential for Harm
https://2medical.news/2021/02/05/screening-for-asymptomatic-carotid-artery-stenosis-lack-of-clinical-benefit-potential-for-harm/
In the Recommendation Statement published in this issue of JAMA,1 the US Preventive Services Task Force (USPTF) has reaffirmed its 2014 recommendation, stating that “The USPTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation),” based on evidence that the harms of screening for carotid artery stenosis in asymptomatic adults outweigh the benefits, with no new evidence that would …
https://2medical.news/2021/02/05/screening-for-asymptomatic-carotid-artery-stenosis-lack-of-clinical-benefit-potential-for-harm/
In the Recommendation Statement published in this issue of JAMA,1 the US Preventive Services Task Force (USPTF) has reaffirmed its 2014 recommendation, stating that “The USPTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation),” based on evidence that the harms of screening for carotid artery stenosis in asymptomatic adults outweigh the benefits, with no new evidence that would …