Update on peripheral artery disease: Epidemiology and evidence-based facts

  • Jun Shu
    Department of Medicine, Albert Einstein College of Medicine, Montefiore University Hospital, New York, NY, USA
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  • Gaetano Santulli
    Corresponding author. Department of Medicine, Albert Einstein College of Medicine, Montefiore University Hospital, New York, NY, USA.
    Department of Medicine, Albert Einstein College of Medicine, Montefiore University Hospital, New York, NY, USA
    Department of Biomedical Advanced Sciences, “Federico II” University, Naples, Italy
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      Peripheral artery disease (PAD) is a progressive disorder characterized by stenosis and/or occlusion of large and medium-sized arteries, other than those that supply the heart (coronary artery disease, CAD) or the brain (cerebrovascular disease). PAD affects the lower extremities more commonly than the upper extremity vessels, and may lead to an recurrent fatigue, cramping sensation, or pain that is known as claudicatio intermittens (intermittent claudication), which is the most recognized symptomatic subset of lower extremity PAD.


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        • American Diabetes Association, ADA
        Cardiovascular disease and risk management: standards of medical care in Diabetes-2018.
        Diabetes Care. 2018; 41: S86-S104
        • Prospective Studies Collaboration
        • Asia Pacific Cohort Studies Collaboration
        Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies.
        Lancet Diabetes Endocrinol. 2018; (in press)
        • Hiatt W.R.
        • Fowkes F.G.
        • Heizer G.
        • et al.
        Ticagrelor versus clopidogrel in symptomatic peripheral artery disease.
        N. Engl. J. Med. 2017; 376: 32-40
        • Hirsch A.T.
        • Criqui M.H.
        • Treat-Jacobson D.
        • et al.
        Peripheral arterial disease detection, awareness, and treatment in primary care.
        J. Am. Med. Assoc. 2001; 286: 1317-1324
        • Wilcox T.
        • Newman J.
        • Maldonado T.
        • et al.
        Peripheral vascular disease risk in diabetic individuals without coronary heart disease.
        Atherosclerosis. 2018; 275: 419-425
        • Newman J.D.
        • Rockman C.B.
        • Kosiborod M.
        • et al.
        Diabetes mellitus is a coronary heart disease risk equivalent for peripheral vascular disease.
        Am. Heart J. 2017; 184: 114-120
        • Haffner S.M.
        • Lehto S.
        • Ronnemaa T.
        • et al.
        Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction.
        N. Engl. J. Med. 1998; 339: 229-234
        • Bulugahapitiya U.
        • Siyambalapitiya S.
        • Sithole J.
        • et al.
        Is diabetes a coronary risk equivalent? Systematic review and meta-analysis.
        Diabet. Med. 2009; 26: 142-148
        • Schramm T.K.
        • Gislason G.H.
        • Kober L.
        • et al.
        Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people.
        Circulation. 2008; 117: 1945-1954
        • Gambardella J.
        • Santulli G.
        Integrating diet and inflammation to calculate cardiovascular risk.
        Atherosclerosis. 2016; 253: 258-261
        • Wannamethee S.G.
        • Shaper A.G.
        • Whincup P.H.
        • et al.
        Impact of diabetes on cardiovascular disease risk and all-cause mortality in older men: influence of age at onset, diabetes duration, and established and novel risk factors.
        Arch. Intern. Med. 2011; 171: 404-410
        • Rana J.S.
        • Liu J.Y.
        • Moffet H.H.
        • et al.
        Diabetes and prior coronary heart disease are not necessarily risk equivalent for future coronary heart disease events.
        J. Gen. Intern. Med. 2016; 31: 387-393
        • Natarajan S.
        • Liao Y.
        • Sinha D.
        • et al.
        Sex differences in the effect of diabetes duration on coronary heart disease mortality.
        Arch. Intern. Med. 2005; 165: 430-435
        • Hoyer C.
        • Sandermann J.
        • Petersen L.J.
        The toe-brachial index in the diagnosis of peripheral arterial disease.
        J. Vasc. Surg. 2013; 58: 231-238
        • Savji N.
        • Rockman C.B.
        • Skolnick A.H.
        • et al.
        Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects.
        J. Am. Coll. Cardiol. 2013; 61: 1736-1743
        • Anand R.G.
        • Ventura H.O.
        • Mehra M.R.
        Is heart failure more prevalent in patients with peripheral arterial disease? A meta-analysis.
        Congest. Heart Fail. 2007; 13: 319-322
        • Marso S.P.
        • Hiatt W.R.
        Peripheral arterial disease in patients with diabetes.
        J. Am. Coll. Cardiol. 2006; 47: 921-929
        • Thukkani A.K.
        • Kinlay S.
        Endovascular intervention for peripheral artery disease.
        Circ. Res. 2015; 116: 1599-1613
        • Steffen L.
        • Duprez D.
        • Boucher J.
        • et al.
        Management of peripheral artery disease.
        Diabetes Spectr. 2008; 21: 171-177
        • Wrobel J.S.
        • Mayfield J.A.
        • Reiber G.E.
        Geographic variation of lower-extremity major amputation in individuals with and without diabetes in the Medicare population.
        Diabetes Care. 2001; 24: 860-864

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