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Suboptimal treatment of risk factors for atherosclerosis in critical limb ischemia

Barani, Jamal LU ; Mattiasson, I. LU ; Lindblad, B. LU and Gottsäter, A. LU (2005) In International Angiology 24(1). p.59-63
Abstract

Aim. The epidemiology of critical limb ischemia (CLI) is insufficiently studied, and treatment of risk factors for atherosclerosis has received less attention in CLI patients than in patients with coronary or precerebral atherosclerosis. The aim of this study was to establish the incidence of CLI and the quality of risk factor treatment in Swedish CLI patients. Methods. During 14 months, 316 consecutive CLI patients were referred to the Malmö Department of Vascular Diseases. Two hundred and fifty-nine (82%) consented to evaluation of intercurrent disease, medication, ankle and arm blood pressures (BP), plasma glucose and lipid levels, phomocysteine, cardiolipin antibodies and activated protein C (APC)-resistance. Results. The incidence... (More)

Aim. The epidemiology of critical limb ischemia (CLI) is insufficiently studied, and treatment of risk factors for atherosclerosis has received less attention in CLI patients than in patients with coronary or precerebral atherosclerosis. The aim of this study was to establish the incidence of CLI and the quality of risk factor treatment in Swedish CLI patients. Methods. During 14 months, 316 consecutive CLI patients were referred to the Malmö Department of Vascular Diseases. Two hundred and fifty-nine (82%) consented to evaluation of intercurrent disease, medication, ankle and arm blood pressures (BP), plasma glucose and lipid levels, phomocysteine, cardiolipin antibodies and activated protein C (APC)-resistance. Results. The incidence of CLI was 38/100 000 inhabitants/year. Patient age was 75±10 years, and BP 147±26/75±14 mmHg. Systolic or diastolic BP above recommended levels (140/90 mmHg) occurred in 137 (53%) patients. P-cholesterol was 4.8±1.2 mMol/L, but cholesterol above recommended level (5 mMol/L) or LDL above recommended level (3 mMol/L) occurred in 125 (48%) patients. Only 24% of patients met national recommendations for both BP and lipid levels. Diabetes mellitus was previously known in 123 (47%) patients, and another 12 (5%) patients showed diabetic fasting glucose levels during the hospital stay. Eightyfour (32%) patients were active, and 72 (28%) were former smokers. Myocardial infarction or angina pectoris had previously been diagnosed in 123 (47%) patients. P-homocysteine was 17±7 μol/l, cardiolipin antibodies occurred in 71 (27%) and APC-resistance in 34 (13%) patients. Conclusion. Patients with CLI show high comorbidity in vascular diseases and high prevalence of modifiable risk factors for atherosclerotic vascular disease. The use of evidence-based medical therapy is suboptimal in this high-risk group.

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Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ischemia, Limb, Risk factors
in
International Angiology
volume
24
issue
1
pages
5 pages
publisher
Minerva Medica
external identifiers
  • scopus:33745291436
  • pmid:15877000
ISSN
0392-9590
language
English
LU publication?
yes
id
76567188-ec70-41f6-9887-df34050f0837
alternative location
https://www.minervamedica.it/en/journals/international-angiology/article.php?cod=R34Y2005N01A0059
date added to LUP
2020-12-11 14:12:27
date last changed
2021-09-01 05:34:07
@article{76567188-ec70-41f6-9887-df34050f0837,
  abstract     = {<p>Aim. The epidemiology of critical limb ischemia (CLI) is insufficiently studied, and treatment of risk factors for atherosclerosis has received less attention in CLI patients than in patients with coronary or precerebral atherosclerosis. The aim of this study was to establish the incidence of CLI and the quality of risk factor treatment in Swedish CLI patients. Methods. During 14 months, 316 consecutive CLI patients were referred to the Malmö Department of Vascular Diseases. Two hundred and fifty-nine (82%) consented to evaluation of intercurrent disease, medication, ankle and arm blood pressures (BP), plasma glucose and lipid levels, phomocysteine, cardiolipin antibodies and activated protein C (APC)-resistance. Results. The incidence of CLI was 38/100 000 inhabitants/year. Patient age was 75±10 years, and BP 147±26/75±14 mmHg. Systolic or diastolic BP above recommended levels (140/90 mmHg) occurred in 137 (53%) patients. P-cholesterol was 4.8±1.2 mMol/L, but cholesterol above recommended level (5 mMol/L) or LDL above recommended level (3 mMol/L) occurred in 125 (48%) patients. Only 24% of patients met national recommendations for both BP and lipid levels. Diabetes mellitus was previously known in 123 (47%) patients, and another 12 (5%) patients showed diabetic fasting glucose levels during the hospital stay. Eightyfour (32%) patients were active, and 72 (28%) were former smokers. Myocardial infarction or angina pectoris had previously been diagnosed in 123 (47%) patients. P-homocysteine was 17±7 μol/l, cardiolipin antibodies occurred in 71 (27%) and APC-resistance in 34 (13%) patients. Conclusion. Patients with CLI show high comorbidity in vascular diseases and high prevalence of modifiable risk factors for atherosclerotic vascular disease. The use of evidence-based medical therapy is suboptimal in this high-risk group.</p>},
  author       = {Barani, Jamal and Mattiasson, I. and Lindblad, B. and Gottsäter, A.},
  issn         = {0392-9590},
  language     = {eng},
  number       = {1},
  pages        = {59--63},
  publisher    = {Minerva Medica},
  series       = {International Angiology},
  title        = {Suboptimal treatment of risk factors for atherosclerosis in critical limb ischemia},
  url          = {https://www.minervamedica.it/en/journals/international-angiology/article.php?cod=R34Y2005N01A0059},
  volume       = {24},
  year         = {2005},
}