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Extermination of atherosclerosis not only in lower extremities


Authors: Jan Piťha 1,2;  Věra Boháčová 3
Authors place of work: Interní klinika 2. LF UK a FN v Motole, Praha 1;  Centrum experimentální medicíny IKEM, Praha 2;  Fórum zdravé výživy, z. s., Praha 3
Published in the journal: Vnitř Lék 2019; 65(12): 788-793
Category:

Summary

Majority of patients with peripheral artery disease (PAD) are affected by coronary artery disease and other vascular complications, often fatal. PAD is, therefore, powerful indicator of a very high risk of death. The main risk factors are smoking and diabetes mellitus; both factors can be corrected very successfully, in theory. In most of patients suffering from PAD mixed dyslipidemia is found, which presents by moderately elevated LDL-cholesterol and triglyceride levels. However, since PAD patients are at a very high risk of cardiovascular death, even moderately elevated LDL-cholesterol levels are very dangerous and should be kept below 1.4 mmol/l. Therefore, these patients require a comprehensive intervention of all risk factors, smoking eradication, diabetes control, but most importantly, LDL-cholesterol reduction. In the following article practical approach how to get risk factors under control is presented.

Keywords:

risk factors – dyslipidemia – lifestyle management – peripheral artery disease – pharmacotherapy


Zdroje
  1. Roztocil K. Zásady péče o pacienty s intermitentními klaudikacemi. [The principles of care for patients with intermittent claudication]. Vnitř Lék 2010; 56(7): 724–726.
  2. Piťha J. Proč umírají pacienti s ICHDK na ICHS a proč často zbytečně? Interní Med 2017; 19(4): 179–185.
  3. Piťha J. Proč nebrzdit volný pád LDL-cholesterolu a nepomlouvat statiny. [Why not to interfere with LDL-cholesterol freefall and why not to talk badly about statins]. Vnitř Lék 2018; 64(12): 1169–1175.
  4. Kullo IJ, Rooke TW. Clinical practice. Peripheral Artery Disease. N Engl J Med 2016; 374(9): 861–871. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMcp1507631>.
  5. Murphy TP, Cutlip DE, Regensteiner JG et al. Supervised exercise, stent revascularization, or medical therapy for claudication due to aortoiliac peripheral artery disease: the CLEVER study. J Am Coll Cardiol 2015; 65(10): 999–1009. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2014.12.043>.
  6. Ruiz-Canela M, Estruch R, Corella D et al. Association of Mediterranean diet with peripheral artery disease: the PREDIMED randomized trial. JAMA 2014; 311(4): 415–417. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2013.280618>.
  7. Karanja N, Lancaster KJ, Vollmer WM et al. Acceptability of sodium-reduced research diets, including the Dietary Approaches To Stop Hypertension diet, among adults with prehypertension and stage 1 hypertension. J Am Diet Assoc 2007; 107(9): 1530–1538. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jada.2007.06.013>.
  8. Piťha J, Boháčová V, Doubková K et al. Projekt intenzivního ovlivnění dyslipidémií u pacientů s ischemickou chorobou dolních končetin. Practicus 2016; 15(10): 9–11.
  9. Shalaeva EV, Saner H, Janabaev BB et al. Tenfold risk increase of major cardiovascular events after high limb amputation with non-compliance for secondary prevention measures. Eur J Prev Cardiol 2017; 24(7): 708–716. Dostupné z DOI: <http://dx.doi.org/10.1177/2047487316687103>.
  10. Zvolská K, Králíková E. Centra pro závislé na tabáku v ČR v roce 2016. [Centers for tobacco-dependent in the Czech Republic in 2016]. Čas Lék Česk 2017; 156(1): 19–23.
  11. Dostupné z WWW: <www.nutriinfo.eu>.
  12. [Task Force Members; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies]. 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis 2019; 290: 140–205. Dostupné z DOI: <http://dx.doi.org/10.1016/j.atherosclerosis.2019.08.014>.
  13. Barry E, Roberts S, Oke J et al. Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions. BMJ 2017; 356: i6538. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.i6538>.
  14. Vallon V, Thomson SC. Targeting renal glucose reabsorption to treat hyperglycemia: the pleiotropic effects of SGLT2 inhibition. Diabetologia 2017; 60(2): 215–225. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–016–4157–3>.
  15. Bonaca MP, Nault P, Giugliano RP et al. Low-Density Lipoprotein Cholesterol Lowering With Evolocumab and Outcomes in Patients With Peripheral Artery Disease: Insights From the FOURIER Trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). Circulation 2018; 137(4): 338–350. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.117.032235>.
  16. Jukema JW, Szarek M, Zijlstra LE et al. [ODYSSEY OUTCOMES Committees and Investigators]. Alirocumab in Patients With Polyvascular Disease and Recent Acute Coronary Syndrome: ODYSSEY OUTCOMES Trial. J Am Coll Cardiol 2019; 74(9): 1167–1176. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2019.03.013>.
  17. Bláha V, Bláha M, Lánská M et al. Postavení lipoproteinové aferézy v současnosti. [Position of lipoprotein apheresis in present]. Vnitř Lék 2015; 61(11): 958–964.
  18. Weiss N. A critical review on the use of lipid apheresis and rheopheresis for treatment of peripheral arterial disease and the diabetic foot syndrome. Semin Dial 2012; 25(2): 220–227. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1525–139X.2011.01036.x>.
  19. Dostupné z WWW: <http://wp.interna-cz.eu/specializovana-pracoviste-pro-lecbu-primarni-hypercholesterolemie-smisene-dyslipidemie/>.
  20. Madsen CM, Kamstrup PR, Langsted A et al. Lp(a) (Lipoprotein[a])-Lowering by 50 mg/dL (105 nmol/L) May Be Needed to Reduce Cardiovascular Disease 20% in Secondary Prevention: A Population-Based Study. Arterioscler Thromb Vasc Biol 2019: ATVBAHA119312951. Dostupné z DOI: <http://dx.doi.org/10.1161/ATVBAHA.119.312951>.
  21. Poredos P, Jezovnik MK. Is aspirin still the drug of choice for management of patients with peripheral arterial disease? Vasa 2013; 42(2): 88–95. Dostupné z DOI: <http://dx.doi.org/10.1024/0301–1526/a000251>.
  22. Mohler ER. Combination antiplatelet therapy in patients with peripheral arterial disease: is the best therapy aspirin, clopidogrel, or both? Catheter Cardiovasc Interv 2009; 74(Suppl 1): S1-S6. Dostupné z DOI: <http://dx.doi.org/10.1002/ccd.21995>.
Štítky
Diabetology Endocrinology Internal medicine
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