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William R Hiatt - One of the best experts on this subject based on the ideXlab platform.
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association of health status scores with cardiovascular and limb outcomes in patients with symptomatic Peripheral Artery disease insights from the euclid examining use of ticagrelor in symptomatic Peripheral Artery disease trial
Journal of the American Heart Association, 2020Co-Authors: William R Hiatt, Lars Norgren, Jeffrey S Berger, Kenneth W Mahaffey, Michael S Conte, Jennifer A Rymer, Hillary Mulder, Kim G Smolderen, Iris BaumgartnerAbstract:Background There are limited data on health status instruments in patients with Peripheral Artery disease and cardiovascular and limb events. We evaluated the relationship between health status cha...
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major adverse limb events and 1 year outcomes after Peripheral Artery revascularization
Journal of the American College of Cardiology, 2018Co-Authors: Connie N Hess, Kevin R Rogers, Tracy Y Wang, Jacob Gundrum, Nancy Allen M Lapointe, William R HiattAbstract:Abstract Background Revascularization is important for symptom treatment and limb salvage in Peripheral Artery disease, yet little data exist on the incidence of post-procedure major adverse limb events (MALE) and longer-term outcomes. Objectives This study sought to characterize hospitalizations and outpatient endovascular revascularizations after Peripheral Artery revascularization, assess temporal trends for outcomes, and identify factors associated with subsequent MALE hospitalization. Methods Patients undergoing Peripheral Artery revascularization between January 1, 2009, and September 30, 2014, in the Premier Healthcare Database were examined for the primary outcome of 1-year MALE hospitalization. Secondary outcomes included 1-year outpatient endovascular revascularization and limb-related, cardiovascular, and all-cause inpatient hospitalizations. Multivariable logistic regression was used to identify factors associated with 1-year MALE hospitalization. Results Among 381,415 revascularized patients, within 1 year post-index revascularization, 10.3% (n = 10,182) had a hospitalization for MALE, 11.0% (n = 42,056) had an outpatient endovascular revascularization, 18.8% (n = 71,663) had a limb-related hospitalization, 12.8% (n = 48,875) had a cardiovascular hospitalization, and 38.9% (n = 148,457) had any inpatient hospitalization. Over the study period, limb-related, cardiovascular, and all-cause hospitalizations decreased, whereas rates of outpatient endovascular revascularizations increased. Male sex, black race, Medicare and Medicaid insurance, diabetes, renal insufficiency, heart failure, smoking, baseline critical or acute limb ischemia, surgical revascularization, and noncardiology operator specialty were significantly associated with increased risk of MALE hospitalization. Conclusions In contemporary practice, hospitalization for MALE occurs in 1 in 10 patients within 1 year after Peripheral revascularization and is associated with patient and procedural factors. These data may inform efforts to improve post-procedure outcomes and limb-related clinical trial design.
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tct 339 types of myocardial infarction in patients with Peripheral Artery disease insights from euclid
Journal of the American College of Cardiology, 2017Co-Authors: Christoph B Olivier, William R Hiatt, Lars Norgren, Jeffrey S Berger, Brian G Katona, Frank W Rockhold, Juuso I Blomster, Schuyler Jones, Daniel Wojdyla, Manesh R PatelAbstract:Patients with Peripheral Artery disease (PAD) are at high risk for myocardial infarction (MI). The characterization of types of MI has not been reported. This analysis aims to characterize types of MI in patients with PAD and the clinical and demographic features of patients with and without MI.
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ticagrelor compared with clopidogrel in patients with prior lower extremity revascularization for Peripheral Artery disease
Circulation, 2017Co-Authors: Schuyler W Jones, Iris Baumgartner, William R Hiatt, Gretchen Heizer, Jeffrey S Berger, Peter Held, Brian G Katona, Michael S Conte, Christopher J White, Kenneth W MahaffeyAbstract:Background:In patients with symptomatic Peripheral Artery disease with a history of limb revascularization, the optimal antithrombotic regimen for long-term management is unknown. Methods:The EUCLI...
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ticagrelor versus clopidogrel in symptomatic Peripheral Artery disease
The New England Journal of Medicine, 2017Co-Authors: William R Hiatt, Iris Baumgartner, Gerry F R Fowkes, Gretchen Heizer, Jeffrey S Berger, Peter Held, Brian G Katona, Kenneth W Mahaffey, L Norgren, Schuyler W JonesAbstract:BackgroundPeripheral Artery disease is considered to be a manifestation of systemic atherosclerosis with associated adverse cardiovascular and limb events. Data from previous trials have suggested that patients receiving clopidogrel monotherapy had a lower risk of cardiovascular events than those receiving aspirin. We wanted to compare clopidogrel with ticagrelor, a potent antiplatelet agent, in patients with Peripheral Artery disease. MethodsIn this double-blind, event-driven trial, we randomly assigned 13,885 patients with symptomatic Peripheral Artery disease to receive monotherapy with ticagrelor (90 mg twice daily) or clopidogrel (75 mg once daily). Patients were eligible if they had an ankle–brachial index (ABI) of 0.80 or less or had undergone previous revascularization of the lower limbs. The primary efficacy end point was a composite of adjudicated cardiovascular death, myocardial infarction, or ischemic stroke. The primary safety end point was major bleeding. The median follow-up was 30 months. ...
Jeffrey S Berger - One of the best experts on this subject based on the ideXlab platform.
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abstract 14653 genome wide association study of Peripheral Artery disease and critical limb ischemia identifies novel genetic loci and coagulation pathways
Circulation, 2020Co-Authors: Chayakrit Krittanawong, Jeffrey S Berger, Jeffrey W Olin, Jagat Narula, Kipp W Johnson, Navneet Narula, Fahd Almulla, Ebaa Alozairi, D O Ron, Girish N NadkarniAbstract:Introduction: The pathogenesis of Peripheral Artery disease (PAD) and critical limb ischemia (CLI) are poorly understood. Hypothesis: We hypothesize that genetic factors related to abnormalities in...
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association of health status scores with cardiovascular and limb outcomes in patients with symptomatic Peripheral Artery disease insights from the euclid examining use of ticagrelor in symptomatic Peripheral Artery disease trial
Journal of the American Heart Association, 2020Co-Authors: William R Hiatt, Lars Norgren, Jeffrey S Berger, Kenneth W Mahaffey, Michael S Conte, Jennifer A Rymer, Hillary Mulder, Kim G Smolderen, Iris BaumgartnerAbstract:Background There are limited data on health status instruments in patients with Peripheral Artery disease and cardiovascular and limb events. We evaluated the relationship between health status cha...
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association of hypertension and arterial blood pressure on limb and cardiovascular outcomes in symptomatic Peripheral Artery disease the euclid trial
Circulation-cardiovascular Quality and Outcomes, 2020Co-Authors: Marat Fudim, Iris Baumgartner, Gerry F R Fowkes, Jeffrey S Berger, Zhen Huang, Frank W Rockhold, Juuso I Blomster, Charles W Hopley, Sarah Kavanagh, Brian G KatonaAbstract:Background: Current guidelines recommend aggressive management of hypertension. Recent evidence suggested potential harm with low blood pressure targets in patients with Peripheral Artery disease. ...
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incidence and factors associated with major amputation in patients with Peripheral Artery disease insights from the euclid trial
Circulation-cardiovascular Quality and Outcomes, 2020Co-Authors: Chandler A Long, Iris Baumgartner, Lars Norgren, Gerry F R Fowkes, Jeffrey S Berger, Brian G Katona, Kenneth W Mahaffey, Juuso I Blomster, Hillary Mulder, Frank W RockholdAbstract:Background: Peripheral Artery disease (PAD) is associated with increased risk of mortality, cardiovascular morbidity, and major amputation. Data on major amputation from a large randomized trial th...
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sex specific risks of major cardiovascular and limb events in patients with symptomatic Peripheral Artery disease
Journal of the American College of Cardiology, 2020Co-Authors: Axel Haine, Connie N Hess, Lars Norgren, Gerry F R Fowkes, Jeffrey S Berger, Brian G Katona, Kenneth W Mahaffey, Juuso I Blomster, Sarah KavanaghAbstract:Abstract Background Patients with Peripheral Artery disease (PAD) have a higher risk of major adverse cardiovascular events (MACE) compared with those without PAD. Objectives The aim of this post hoc analysis was to evaluate sex-specific differences in MACE and limb events in the EUCLID (Examining Use of Ticagrelor in PAD) trial. Methods Cox proportional hazards models were used to compare time-to-event outcomes stratified by sex. Covariates were introduced after adjusted model selection. Results EUCLID enrolled 13,885 patients with PAD (28% women [n = 3,888]). PAD severity and medical treatment were comparable between sexes, whereas prior lower extremity revascularization was reported less frequently in women (54.8% vs. 57.3%; p = 0.006). Women were older (mean ± SD age: 67.8 ± 8.9 vs. 66.1 ± 8.2 years; p Conclusions Although women with PAD are at lower risk for MACE and all-cause mortality, risk for limb events was similar between sexes over a mean follow-up of 30 months. Understanding sex-specific differences and dissociation between baseline cardiovascular risk and subsequent cardiovascular events requires further investigation. (A Study Comparing Cardiovascular Effects of Ticagrelor and Clopidogrel in Patients With Peripheral Artery Disease [EUCLID]; NCT01732822)
Kunihiro Matsushita - One of the best experts on this subject based on the ideXlab platform.
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physical activity and subsequent risk of hospitalization with Peripheral Artery disease and critical limb ischemia in the aric study
Journal of the American Heart Association, 2019Co-Authors: Shoshana H Ballew, Kunihiro Matsushita, Elizabeth Selvin, Lucia Kwak, Corey A Kalbaugh, Jennifer A Schrack, Moyses SzkloAbstract:Background Whether physical activity is a determinant of Peripheral Artery disease (PAD) remains unclear. We therefore assessed the association of physical activity (amount and intensity) with subs...
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contributions of hiv hepatitis c virus and traditional vascular risk factors to Peripheral Artery disease in women
AIDS, 2019Co-Authors: Emily R Cedarbaum, Kunihiro Matsushita, Rebecca Scherzer, Jennifer C Price, Adaora A Adimora, Marcas M Bamman, Mardge H Cohen, Margaret A Fischl, Igho OfotokunAbstract:Objectives:HIV and hepatitis C virus (HCV) have been associated with cardiovascular disease (CVD), but it is unclear whether HIV and HCV are also associated with Peripheral Artery disease (PAD). We examined the association of HIV, HCV, and traditional CVD risk factors with PAD in the Women's Interag
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lifetime risk of lower extremity Peripheral Artery disease defined by ankle brachial index in the united states
Journal of the American Heart Association, 2019Co-Authors: Kunihiro Matsushita, Michael H Criqui, Morgan E Grams, Shoshana H Ballew, Yingying Sang, Hongyan Ning, Eric K H Chow, Elizabeth Selvin, Matthew A Allison, Josef CoreshAbstract:Background There are no available lifetime risk estimates of lower‐extremity Peripheral Artery disease (PAD). Methods and Results Using data from 6 US community‐based cohorts and the vital statisti...
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associations of obesity with incident hospitalization related to Peripheral Artery disease and critical limb ischemia in the aric study
Journal of the American Heart Association, 2018Co-Authors: Caitlin W Hicks, Elizabeth Selvin, Chao Yang, Chiadi E Ndumele, Aaron R Folsom, Gerardo Heiss, James H Black, Kunihiro MatsushitaAbstract:Background We conducted an analysis of data from the ARIC (Atherosclerosis Risk in Communities) study to assess the independent association of obesity with Peripheral Artery disease (PAD) and criti...
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abstract mp14 proteinuria is associated with a greater risk of lower limb amputation in patients with Peripheral Artery disease
Circulation, 2018Co-Authors: Jungim Shin, Alex R Chang, Morgan E Grams, Josef Coresh, Kunihiro MatsushitaAbstract:Introduction: Proteinuria is shown to be associated with increased risk of Peripheral Artery disease (PAD). However, its association with the risk of lower limb amputation in patients with PAD is u...
Emile R Mohler - One of the best experts on this subject based on the ideXlab platform.
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effects of exercise training on calf muscle oxygen extraction and blood flow in patients with Peripheral Artery disease
Journal of Applied Physiology, 2017Co-Authors: Wesley B Baker, Steven S Schenkel, Malavika Chandra, David R Busch, Erin K Englund, Kathryn H Schmitz, Arjun G Yodh, Thomas F Floyd, Emile R MohlerAbstract:We report on noninvasive optical measurements of skeletal muscle blood flow and oxygen extraction dynamics before/during/after treadmill exercise in Peripheral Artery disease patients who experienc...
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multiparametric assessment of vascular function in Peripheral Artery disease dynamic measurement of skeletal muscle perfusion blood oxygen level dependent signal and venous oxygen saturation
Circulation-cardiovascular Imaging, 2015Co-Authors: Erin K Englund, Emile R Mohler, Michael C Langham, Sarah J Ratcliffe, Molly Fanning, Felix W Wehrli, Thomas F FloydAbstract:Background— Endothelial dysfunction present in patients with Peripheral Artery disease may be better understood by measuring the temporal dynamics of blood flow and oxygen saturation during reactive hyperemia than by conventional static measurements. Methods and Results— Perfusion, Intravascular Venous Oxygen saturation, and T2* (PIVOT), a recently developed MRI technique, was used to measure the response to an ischemia–reperfusion paradigm in 96 patients with Peripheral Artery disease of varying severity and 10 healthy controls. Perfusion, venous oxygen saturation SvO2, and T2* were each quantified in the calf at 2-s temporal resolution, yielding a dynamic time course for each variable. Compared with healthy controls, patients had a blunted and delayed hyperemic response. Moreover, patients with lower ankle-brachial index had (1) a more delayed reactive hyperemia response time, manifesting as an increase in time to peak perfusion in the gastrocnemius, soleus, and peroneus muscles, and in the anterior compartment, (2) an increase in the time to peak T2* measured in the soleus muscle, and (3) a prolongation of the posterior tibial vein SvO2 washout time. Intrasession and intersession repeatability were also assessed. Results indicated that time to peak perfusion and time to peak T2* were the most reliable extracted time course metrics. Conclusions— Perfusion, dynamic SvO2, and T2* response times after induced ischemia are highly correlated with Peripheral Artery disease severity. Combined imaging of Peripheral microvascular blood flow and dynamics of oxygen saturation with Perfusion, intravascular SvO2, and T2* may be a useful tool to investigate the pathophysiology of Peripheral Artery disease.
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supervised exercise versus primary stenting for claudication resulting from aortoiliac Peripheral Artery disease six month outcomes from the claudication exercise versus endoluminal revascularization clever study
Circulation, 2012Co-Authors: Timothy P Murphy, Judith G Regensteiner, Donald E Cutlip, Emile R Mohler, David J Cohen, Matthew R Reynolds, Joseph M Massaro, Beth A Lewis, Joselyn Cerezo, Niki C OldenburgAbstract:Background— Claudication is a common and disabling symptom of Peripheral Artery disease that can be treated with medication, supervised exercise (SE), or stent revascularization (ST). Methods and Results— We randomly assigned 111 patients with aortoiliac Peripheral Artery disease to receive 1 of 3 treatments: optimal medical care (OMC), OMC plus SE, or OMC plus ST. The primary end point was the change in peak walking time on a graded treadmill test at 6 months compared with baseline. Secondary end points included free-living step activity, quality of life with the Walking Impairment Questionnaire, Peripheral Artery Questionnaire, Medical Outcomes Study 12-Item Short Form, and cardiovascular risk factors. At the 6-month follow-up, change in peak walking time (the primary end point) was greatest for SE, intermediate for ST, and least with OMC (mean change versus baseline, 5.8±4.6, 3.7±4.9, and 1.2±2.6 minutes, respectively; P P =0.02 for ST versus OMC, and P =0.04 for SE versus ST). Although disease-specific quality of life as assessed by the Walking Impairment Questionnaire and Peripheral Artery Questionnaire also improved with both SE and ST compared with OMC, for most scales, the extent of improvement was greater with ST than SE. Free-living step activity increased more with ST than with either SE or OMC alone (114±274 versus 73±139 versus −6±109 steps per hour), but these differences were not statistically significant. Conclusions— SE results in superior treadmill walking performance than ST, even for those with aortoiliac Peripheral Artery disease. The contrast between better walking performance for SE and better patient-reported quality of life for ST warrants further study. Clinical Trial Registration— URL: http://clinicaltrials.gov/ct/show/NCT00132743?order=1. Unique identifier: NCT00132743.
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supervised exercise versus primary stenting for claudication resulting from aortoiliac Peripheral Artery disease six month outcomes from the claudication exercise versus endoluminal revascularization clever study
Circulation, 2012Co-Authors: Timothy P Murphy, Judith G Regensteiner, Donald E Cutlip, Emile R Mohler, David J Cohen, Matthew R Reynolds, Joseph M Massaro, Beth A Lewis, Joselyn Cerezo, Niki C OldenburgAbstract:Background—Claudication is a common and disabling symptom of Peripheral Artery disease that can be treated with medication, supervised exercise (SE), or stent revascularization (ST). Methods and Results—We randomly assigned 111 patients with aortoiliac Peripheral Artery disease to receive 1 of 3 treatments: optimal medical care (OMC), OMC plus SE, or OMC plus ST. The primary end point was the change in peak walking time on a graded treadmill test at 6 months compared with baseline. Secondary end points included free-living step activity, quality of life with the Walking Impairment Questionnaire, Peripheral Artery Questionnaire, Medical Outcomes Study 12-Item Short Form, and cardiovascular risk factors. At the 6-month follow-up, change in peak walking time (the primary end point) was greatest for SE, intermediate for ST, and least with OMC (mean change versus baseline, 5.8±4.6, 3.7±4.9, and 1.2±2.6 minutes, respectively; P<0.001 for the comparison of SE versus OMC, P=0.02 for ST versus OMC, and P=0.04 for ...
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mean platelet volume and prevalence of Peripheral Artery disease the national health and nutrition examination survey 1999 2004
Atherosclerosis, 2010Co-Authors: Jeffrey S Berger, Luis H Eraso, Emile R MohlerAbstract:Objectives We sought to determine whether mean platelet volume (MPV) is associated with the prevalence of Peripheral Artery disease (PAD).
Niki C Oldenburg - One of the best experts on this subject based on the ideXlab platform.
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supervised exercise versus primary stenting for claudication resulting from aortoiliac Peripheral Artery disease six month outcomes from the claudication exercise versus endoluminal revascularization clever study
Circulation, 2012Co-Authors: Timothy P Murphy, Judith G Regensteiner, Donald E Cutlip, Emile R Mohler, David J Cohen, Matthew R Reynolds, Joseph M Massaro, Beth A Lewis, Joselyn Cerezo, Niki C OldenburgAbstract:Background— Claudication is a common and disabling symptom of Peripheral Artery disease that can be treated with medication, supervised exercise (SE), or stent revascularization (ST). Methods and Results— We randomly assigned 111 patients with aortoiliac Peripheral Artery disease to receive 1 of 3 treatments: optimal medical care (OMC), OMC plus SE, or OMC plus ST. The primary end point was the change in peak walking time on a graded treadmill test at 6 months compared with baseline. Secondary end points included free-living step activity, quality of life with the Walking Impairment Questionnaire, Peripheral Artery Questionnaire, Medical Outcomes Study 12-Item Short Form, and cardiovascular risk factors. At the 6-month follow-up, change in peak walking time (the primary end point) was greatest for SE, intermediate for ST, and least with OMC (mean change versus baseline, 5.8±4.6, 3.7±4.9, and 1.2±2.6 minutes, respectively; P P =0.02 for ST versus OMC, and P =0.04 for SE versus ST). Although disease-specific quality of life as assessed by the Walking Impairment Questionnaire and Peripheral Artery Questionnaire also improved with both SE and ST compared with OMC, for most scales, the extent of improvement was greater with ST than SE. Free-living step activity increased more with ST than with either SE or OMC alone (114±274 versus 73±139 versus −6±109 steps per hour), but these differences were not statistically significant. Conclusions— SE results in superior treadmill walking performance than ST, even for those with aortoiliac Peripheral Artery disease. The contrast between better walking performance for SE and better patient-reported quality of life for ST warrants further study. Clinical Trial Registration— URL: http://clinicaltrials.gov/ct/show/NCT00132743?order=1. Unique identifier: NCT00132743.
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supervised exercise versus primary stenting for claudication resulting from aortoiliac Peripheral Artery disease six month outcomes from the claudication exercise versus endoluminal revascularization clever study
Circulation, 2012Co-Authors: Timothy P Murphy, Judith G Regensteiner, Donald E Cutlip, Emile R Mohler, David J Cohen, Matthew R Reynolds, Joseph M Massaro, Beth A Lewis, Joselyn Cerezo, Niki C OldenburgAbstract:Background—Claudication is a common and disabling symptom of Peripheral Artery disease that can be treated with medication, supervised exercise (SE), or stent revascularization (ST). Methods and Results—We randomly assigned 111 patients with aortoiliac Peripheral Artery disease to receive 1 of 3 treatments: optimal medical care (OMC), OMC plus SE, or OMC plus ST. The primary end point was the change in peak walking time on a graded treadmill test at 6 months compared with baseline. Secondary end points included free-living step activity, quality of life with the Walking Impairment Questionnaire, Peripheral Artery Questionnaire, Medical Outcomes Study 12-Item Short Form, and cardiovascular risk factors. At the 6-month follow-up, change in peak walking time (the primary end point) was greatest for SE, intermediate for ST, and least with OMC (mean change versus baseline, 5.8±4.6, 3.7±4.9, and 1.2±2.6 minutes, respectively; P<0.001 for the comparison of SE versus OMC, P=0.02 for ST versus OMC, and P=0.04 for ...