156 results on '"Schernthaner GH"'
Search Results
2. Beurteilung des klinischen Denkens von Studierenden am Ende des Klinisch-Praktischen Jahres: Das Portfolio als geeignetes Instrument? [Bericht über Entwicklungsprozess]
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Hofhansl, A, Anvari-Pirsch, A, Horn, W, Kainberger, F, Kirnbauer, I, Rieder, A, Schernthaner, GH, Steinlechner, B, and Zlabinger, G
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Problemstellung/Ziele: An der MedUni Wien wurde 2014 erstmals ein Klinisch-Praktisches Jahr (KPJ) als 6. Studienjahr eingeführt. Die begleitende Leistungsdokumentation der Studierenden erfolgt mittels Logbuch und Portfolio. Zentraler Bestandteil dieser Mappe sind gesammelte Ausarbeitungen [zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)
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- 2018
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3. Which is the eligible patient to be treated with pioglitazone? The espert view
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FARINARO, EDUARDO, Avogaro A., Betteridge J., Bonadonna R., Campbell IW, Schernthaner GH, Staels B., Crepaldi G., Farinaro, Eduardo, Avogaro, A., Betteridge, J., Bonadonna, R., Campbell, Iw, Schernthaner, Gh, Staels, B., and Crepaldi, G.
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- 2011
4. Which is the eligible patient to be treatedwith pioglitazone? The expert view
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ANGELO AVOGARO, Federici, M., Betteridge, J., Bonadonna, R., Campbell, Iw, Schernthaner, Gh, Staels, B., Farinaro, E., and Crepaldi, Gaetano
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- 2011
5. Abfall von sCD 163 nach deutlichem Gewichtsverlust induziert durch bariatrische Chirurgie
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Krzizek, EC, primary, Brix, JM, additional, Ursli, M, additional, Bräuer, A, additional, Kopp, HP, additional, Hoebaus, C, additional, Schernthaner, GH, additional, and Schernthaner, G, additional
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- 2013
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6. Könnte Insulin über die Beeinflussung von Matrixmetalloproteinasen einen proatherogenen Effekt ausüben?
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Wressnegger, A, primary, Pesau, G, additional, Nagl, K, additional, Obendorf, F, additional, Hoebaus, C, additional, Koppensteiner, R, additional, Schernthaner, G, additional, and Schernthaner, GH, additional
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- 2013
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7. Vitamin D ist nicht assoziiert mit diabetischer Retinopathie bei Patienten mit Typ 1 und Typ 2 Diabetes
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Krzizek, EC, primary, Brix, JM, additional, Dossenbach-Glaninger, A, additional, Brunner, S, additional, Schernthaner, GH, additional, and Schernthaner, G, additional
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- 2013
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8. Hypoglykämie bei Patienten nach bariatrischer Chirurgie
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Brix, JM, primary, Kopp, HP, additional, Schernthaner, GH, additional, Schermann, M, additional, Kriwanek, S, additional, Roka, R, additional, and Schernthaner, G, additional
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- 2013
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9. Könnten Matrix-Metalloproteasen in das kardiovaskulären Risiko von Patienten mit diabetischer Nephropathie involviert sein?
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Pesau, G, primary, Obendorf, F, additional, Kaltenboeck, R, additional, Wressnegger, A, additional, Hoebaus, C, additional, Schernthaner, G, additional, Koppensteiner, R, additional, and Schernthaner, GH, additional
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- 2012
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10. Aktivierung und Adhäsion von Blutplättchen bei Patienten mit Adipositas Grad III vor und nach Gewichtsverlust durch Roux-en-Y Magenbypass
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Blechinger, S, primary, Satler, M, additional, Elhenicky, M, additional, Kaltenboeck, R, additional, Hoellerl, F, additional, Hoebaus, C, additional, Kopp, HP, additional, Brix, JM, additional, Schernthaner, G, additional, and Schernthaner, GH, additional
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- 2012
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11. Mädchen und Knaben mit Typ 1 Diabetes mellitus unterscheiden sich in Bezug auf zugrundeliegender Pathomechanismen und Anfälligkeit für Atherosklerose
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Nagl, K, primary, Schober, E, additional, Rami, B, additional, Willfort-Ehringer, A, additional, Fritsch, M, additional, Schernthaner, G, additional, and Schernthaner, GH, additional
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- 2012
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12. Verminderung von Endothelial Progenitor Cells (EPC) in Patienten mit Typ-2-Diabetes mellitus (T2DM) mit Normalbuminurie (NORM), Mikroalbuminurie (MIA) und Makroalbuminurie (MA)
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Brix, J, primary, Satler, M, additional, Feder, A, additional, Hoellerl, F, additional, Elhenicky, M, additional, Koppensteiner, R, additional, Schernthaner, G, additional, and Schernthaner, GH, additional
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- 2008
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13. Research update for articles published in EJCI in 2011
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Pasquale Abete, Christopher Adlbrecht, Stelios F. Assimakopoulos, Nancy Côté, Robin P.F. Dullaart, Helen V. Evsyukova, Te-Chao Fang, Nandu Goswami, Helmut Hinghofer-Szalkay, Yi-Lwun Ho, Clemens Hoebaus, Martin Hülsmann, Olafur S. Indridason, Ivana Kholová, Yen-Hung Lin, Mauro Maniscalco, Patrick Mathieu, Hiroki Mizukami, Gjin Ndrepepa, Andreas Roessler, Silvia Sánchez-Ramón, Francesca Santamaria, Gerit-Holger Schernthaner, Chrisoula D. Scopa, Keith M. Sharp, Gudrun V. Skuladottir, Olivier Steichen, Peter Stenvinkel, Marta Tejera-Alhambra, Gianluca Testa, Frank L.J. Visseren, Jan Westerink, Anna Witasp, Soroku Yagihashi, Seppo Ylä-Herttuala, Abete, Pasquale, Adlbrecht, C, Assimakopoulos, Sf, Côté, N, Dullaart, Rp, Evsyukova, Hv, Fang, Tc, Goswami, N, Hinghofer Szalkay, H, Ho, Yl, Hoebaus, C, Hülsmann, M, Indridason, O, Kholová, I, Lin, Yh, Maniscalco, M, Mathieu, P, Mizukami, H, Ndrepepa, G, Roessler, A, Sánchez Ramón, S, Santamaria, Francesca, Schernthaner, Gh, Scopa, Cd, Sharp, Km, Skuladottir, Gv, Steichen, O, Stenvinkel, P, Tejera Alhambra, M, Testa, G, Visseren, Fl, Westerink, J, Witasp, A, Yagihashi, S, and Ylä Herttuala, S.
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CHRONIC KIDNEY-DISEASE ,EPITHELIAL-CELL PROLIFERATION ,SENSITIVE TROPONIN-T ,Clinical Biochemistry ,PRIMARY CILIARY DYSKINESIA ,PHOSPHOLIPASE A(2) MASS ,General Medicine ,THYROID-STIMULATING HORMONE ,PRIMARY ALDOSTERONISM ,Biochemistry ,NASAL NITRIC-OXIDE ,FARNESOID X RECEPTOR ,CHRONIC HEART-FAILURE - Abstract
Depression affects 13–77% of patients with chronic heart failure (CHF), and it is independently associated with hospitalization and mortality in elderly CHF patients [14]. Depression is an obstacle to CHF self-care, and it is associated with nonadherence to medications and diet recommendations [14]. Particularly in elders, depression is associated with impaired cognition, and it may interfere with the ability to learn, perceive symptoms, judge severity of symptoms and make decisions about symptoms [14]. Finally, depression often leads to social isolation and therefore to a poor social support, which is important in self-care [15]. Antidepressant drug in CHF patients with depression should be considered, especially selective serotonin reuptake [14]. The Sertraline Against Depression and Heart Disease in Chronic Heart Failure study confirms these data [16]. Finally, physical activity whose positive effect on the heart is still unknown [17], appears to be effective in reducing depression in elderly patients with CHF
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- 2013
14. Is the current therapeutic armamentarium in diabetes enough to control the epidemic and its consequences? What are the current shortcomings?
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Eduardo Farinaro, Gerit-Holger Schernthaner, Riccardo C. Bonadonna, Antonia Trichopoulou, Ian W Campbell, Dario Giugliano, Tina Vilsbøll, Æ John Betteridge, Bart Staels, Eberhard Standl, Giugliano, D, Standl, E, Vilsbøll, T, Betteridge, J, Bonadonna, R, Campbell, Iw, Schernthaner, Gh, Staels, B, Trichopoulou, A, Farinaro, Eduardo, Giugliano, Dario, and Farinaro, E.
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Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Psychological intervention ,hypoglycemic agents ,Type 2 diabetes ,Disease ,Gastric Inhibitory Polypeptide ,"type 2 diabetes ,glucose toxicity" ,Incretins ,Disease Outbreaks ,Endocrinology ,Glucagon-Like Peptide 1 ,Diabetes mellitus ,Internal Medicine ,medicine ,Diabetes Mellitus ,Humans ,Disease management (health) ,Intensive care medicine ,Cause of death ,business.industry ,General Medicine ,medicine.disease ,Surgery ,Tolerability ,Diabetes Mellitus, Type 2 ,Hyperglycemia ,Hypertension ,Life expectancy ,Female ,business - Abstract
The prevalence of diabetes is expected to rise together with an increase in morbidity and a reduction in life expectancy. A leading cause of death is cardiovascular disease, and hypertension and diabetes are additive risk factors for this complication. Selected treatment options should neither increase cardiovascular risk in patients with diabetes, nor increase risk of hyperglycaemia in patients with hypertension. The efficacy of present antihyperglycaemic agents is limited and new therapies, such as incretin-targeted agents, are under development. Even though most patients do not achieve glycated haemoglobin targets, trial data show that such interventions reduce the incidence of macrovascular events; however, intensive lowering may be detrimental in patients with existing cardiovascular disease. Currently available oral drugs do not address the key driver of type 2 diabetes--loss of functional beta-cell mass. In the future, new oral treatments must improve this, whilst providing durable blood glucose control and long-term tolerability.
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- 2009
15. Letter: Answer to "Trefoil Factor-3 and Peripheral Artery Disease: Reason or Result".
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Pesau G, Zierfuss B, Hoebaus C, Koppensteiner R, and Schernthaner GH
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- 2024
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16. Urinary vanin-1 as a novel biomarker for survival in peripheral artery disease.
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Zierfuss B, Karlinger A, Bojic M, Koppensteiner R, Schernthaner GH, and Höbaus C
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- Humans, Male, Female, Aged, Austria epidemiology, Middle Aged, Risk Factors, Time Factors, Risk Assessment, Prognosis, Enzyme-Linked Immunosorbent Assay, Creatinine urine, Creatinine blood, Amidohydrolases urine, Cause of Death, GPI-Linked Proteins urine, Glomerular Filtration Rate, Aged, 80 and over, Oxidative Stress, Albuminuria diagnosis, Albuminuria urine, Albuminuria mortality, Renal Insufficiency, Chronic mortality, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic urine, Renal Insufficiency, Chronic physiopathology, Kidney physiopathology, Prospective Studies, Proportional Hazards Models, Urinalysis, Peripheral Arterial Disease mortality, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease urine, Biomarkers urine, Biomarkers blood, Predictive Value of Tests
- Abstract
Background: Chronic kidney disease is associated with increased rates of incidence, morbidity, and mortality in lower-extremity peripheral artery disease (PAD). No specific marker for a functional risk assessment of kidney disease in PAD is known, especially at the early stages. Thus, we speculated that urinary vanin-1 (uVNN1), a marker of oxidative stress even in early kidney injury, could further stratify outcome assessment in patients with PAD., Methods: Patients with stable PAD ( n = 304) of the Vienna medical cohort were followed up for up to 10 years and the outcome was assessed by central death database queries. uVNN1 was measured by enzyme-linked immunosorbent assay (ELISA) at study inclusion and normalized to urinary creatinine (uVNN1/Cr). During the observation time (9.3, 7.0-9.8 years), 104 patients died, 54.8% of which were due to cardiovascular causes., Results: uVNN1/Cr was associated with a urine albumin-creatinine ratio (UACR) ( R = 0.166, p = 0.004) but not with an estimated glomerular filtration rate ( R = 0.102, p = 0.077). Levels of uVNN1/Cr did not differ between asymptomatic and symptomatic PAD ( p = 0.406). Kaplan-Meier curves showed a clear-cut association with higher all-cause (log-rank p = 0.034) and cardiovascular mortality (log-rank p = 0.032) with higher uVNN1/Cr levels. Similarly, significant associations for all-cause (hazard ratio [HR] 1.34, 95% CI [1.08-1.67], p = 0.009) and cardiovascular mortality (HR 1.45, 95% CI [1.06-1.99], p = 0.020) could be seen in multivariable Cox regression models., Conclusions: uVNN1/Cr showed an independent association with both all-cause and cardiovascular mortality in patients with PAD and was associated with early kidney disease. Thus, uVNN1 could be a useful marker for risk stratification of kidney disease in PAD., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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17. A RAND/UCLA-Modified VAS Study on Telemedicine, Telehealth, and Virtual Care in Daily Clinical Practice of Vascular Medicine.
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Pillon S, Gomatou G, Dimakakos E, Stanek A, Pecsvarady Z, Kozak M, Wautrecht JC, Farkas K, Schernthaner GH, Catalano M, Blinc A, Gerotziafas G, Poredoš P, De Marchi S, Gschwandtner ME, Kolossváry E, Sprynger M, Fazeli B, Liew A, Marschang P, Szuba A, Suput D, Edmonds M, Manu C, Schaefer CA, Marakomichelakis G, Vrkić Kirhmajer M, Spaak J, Kotteas E, Lessiani G, Colgan MP, Righini M, Lichtenberg M, Schlager O, Canning C, Marcoccia A, Kollias A, and Spreafico A
- Abstract
Background: Telemedicine is increasingly used in several fields of healthcare, including vascular medicine. This study aimed to investigate the views of experts and propose clinical practice recommendations on the possible applications of telemedicine in vascular medicine. Methods: A clinical guidance group proposed a set of 67 clinical practice recommendations based on the synthesis of current evidence and expert opinion. The Telemedicine Vascular Medicine Working Group included 32 experts from Europe evaluating the appropriateness of each clinical practice recommendation based on published RAND/UCLA methodology in two rounds. Results: In the first round, 60.9% of clinical practice recommendations were rated as appropriate, 35.9% as uncertain, and 3.1% as inappropriate. The strongest agreement (a median value of 10) was reached on statements regarding the usefulness of telemedicine during the 2019 coronavirus disease (COVID-19) pandemic, its usefulness for geographical areas that are difficult to access, and the superiority of video calls compared to phone calls only. The lowest degree of agreement (a median value of 2) was reported on statements regarding the utility of telemedicine being limited to the COVID-19 pandemic and regarding the applicability of teleconsultation in the diagnosis and management of abdominal aortic aneurysm. In the second round, 11 statements were re-evaluated to reduce variability. Conclusions: This study highlights the levels of agreement and the points that raise concern on the use of telemedicine in vascular medicine. It emphasizes the need for further clarification on various issues, including infrastructure, logistics, and legislation.
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- 2024
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18. Serum Trefoil Factor-3 Predicts Survival in Peripheral Artery Disease.
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Pesau G, Zierfuss B, Hoebaus C, Koppensteiner R, and Schernthaner GH
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Trefoil factor 3 (TFF3) has been studied in processes leading to atherosclerosis. Data are scarce in manifest disease and missing in peripheral artery disease (PAD). This study aims to elucidate TFF3 with disease stages, degrees of atherosclerosis, and outcomes. TFF3 was measured in serum in 364 PAD patients without critical limb ischemia and mild to moderate chronic kidney disease (CKD). Mortality data were retrieved from the Austrian central death registry (median observation 9.6 years). Survival analyses were performed using Cox regression and the Kaplan-Meier method. A negative association between ankle-brachial index and TFF3 ( P < .001) was observed, while levels were similar in asymptomatic and symptomatic PAD. TFF3 increased with history of cardiovascular and cerebrovascular disease ( P < .001). TTF3 was associated with the estimated glomerular filtration rate (R = -0.617, P < .001) and urinary albumin-creatinine ratio (R = 0.229, P < .001). One SD increase in TFF3 showed a worsening in all-cause mortality (hazard ratio 1.68, CI 1.37-2.05) which persisted after multiple adjustment for cardiovascular risk, inflammatory, and angiogenetic markers (hazard ratio 1.35, CI 1.01-1.81). This study is the first to link TFF3 with both disease markers and outcomes in PAD. TFF3 demonstrated associations with renal function, PAD severity measured by ankle-brachial index, and additional atherosclerotic burden in PAD., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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- 2024
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19. Peripheral Arterial Disease: An Underestimated Aspect of Menopause-related Cardiovascular Disease.
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Anagnostis P, Mikhailidis DP, Blinc A, Jensterle M, Ježovnik MK, Schernthaner GH, Antignani PL, Studen KB, Sabovic M, and Poredos P
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- Humans, Female, Risk Factors, Cardiovascular Diseases physiopathology, Cardiovascular Diseases epidemiology, Cardiovascular Diseases diagnosis, Prognosis, Risk Assessment, Menopause, Peripheral Arterial Disease physiopathology, Peripheral Arterial Disease epidemiology, Peripheral Arterial Disease diagnosis
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- 2024
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20. Thyroid Disorders and Peripheral Arterial Disease.
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Studen KB, Gaberscek S, Zaletel K, Blinc A, Sabovic M, Schernthaner GH, Anagnostis P, Antignani PL, Jensterle M, Mikhailidis DP, and Poredos P
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- Humans, Hypothyroidism complications, Hypothyroidism diagnosis, Hypothyroidism epidemiology, Hyperthyroidism complications, Hyperthyroidism diagnosis, Hyperthyroidism epidemiology, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology
- Abstract
Hypothyroidism and hyperthyroidism, both overt and subclinical, are associated with increased risk of cardiovascular morbidity and mortality. The association between thyroid-stimulating hormone levels and cardiovascular risk has been demonstrated in large epidemiological studies and meta-analyses and is now considered a U-shaped curve. Several pathophysiological mechanisms linking thyroid and cardiovascular disease are known; however, specific clinical complications of peripheral arterial disease as endpoints of clinical trials have not been adequately investigated. The potential mechanisms linking hypothyroidism and peripheral arterial disease are endothelial dysfunction, blood pressure changes, dyslipidemia, and low-grade systemic inflammation. The potential mechanisms linking hyperthyroidism and peripheral arterial disease are hyperdynamic circulation, elevated systolic blood pressure, hypercoagulability, and possibly increased arterial inflammation., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2024
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21. Hyperparathyroidism and Peripheral Arterial Disease.
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Antignani PL, Jezovnik MK, Blinc A, Mikhailidis DP, Anagnostis P, Schernthaner GH, Jensterle M, Studen KB, Sabovic M, and Poredos P
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- Humans, Animals, Risk Factors, Parathyroidectomy, Vascular Calcification physiopathology, Vascular Calcification etiology, Hyperparathyroidism, Secondary etiology, Hyperparathyroidism, Secondary physiopathology, Treatment Outcome, Biomarkers blood, Prognosis, Calcium metabolism, Calcium blood, Peripheral Arterial Disease physiopathology, Hyperparathyroidism, Primary physiopathology, Hyperparathyroidism, Primary complications, Hyperparathyroidism, Primary diagnosis, Parathyroid Hormone blood
- Abstract
Primary hyperparathyroidism (PHPT) is presented in various forms, including classic PHPT, characterised by increased parathyroid hormone (PTH) secretion, normohormonal PHPT, and normocalcaemic PHPT. Secondary hyperparathyroidism is characterised by increased PTH secretion triggered by factors such as vitamin D deficiency and kidney failure. This review aims to discuss the involvement of hyperparathyroidism (HPT) in atherosclerosis, including peripheral arterial disease (PAD). The increased level of PTH is involved in developing subclinical and overt vascular diseases, encompassing endothelial dysfunction, vascular stiffness, hypertension, and coronary and peripheral arterial diseases. It has been consistently associated with an augmented risk of cardiovascular morbidity and mortality, independent of classical risk factors for atherosclerosis. Chronic hypercalcemia associated with increased levels of PTH contributes to the development of calcification of vessel walls and atherosclerotic plaques. Vascular calcification can occur in the intima or media of the arterial wall and is associated with stiffness of peripheral arteries, which the formation of atherosclerotic plaques and narrowing of the vessel lumen can follow. For treating hyperparathyroidism, particularly SHPT, calcimimetics, novel phosphorus binders and novel vitamin D receptor activators are used. However, they are ineffective in severe PHPT. Therefore, parathyroidectomy remains the primary therapeutic option of PHPT., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2024
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22. Endocrine Disorders and Peripheral Arterial Disease - A Series of Reviews Cushing Syndrome-Cortisol Excess.
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Poredoš P, Schernthaner GH, Blinc A, Mikhailidis DP, Jensterle M, Anagnostis P, Antignani PL, Studen KB, Šabović M, and Ježovnik MK
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- Humans, Risk Factors, Animals, Hydrocortisone blood, Cushing Syndrome physiopathology, Cushing Syndrome diagnosis, Cushing Syndrome complications, Peripheral Arterial Disease physiopathology, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease metabolism
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Cushing syndrome (CS), characterised by endogenous or exogenous glucocorticoid hormone excess, is associated with several systemic complications, including impaired glucose metabolism, which often becomes clinically manifest as diabetes mellitus (DM). In addition, CS can harm the arterial wall because of hyperglycaemia, dyslipidaemia, hepatic steatosis, and central obesity. These metabolic disorders promote atherosclerosis by synthesising adipokines, leptin, and proinflammatory cytokines. Lower limb arterial complications in CS are common and significantly impact morbidity and mortality. Furthermore, CS, in combination with DM, is likely to cause more diffuse vascular disease that predominantly affects distal arterial beds. In conclusion, CS promotes atherosclerosis, including peripheral artery disease, by causing functional and morphological deterioration of the arterial vessel wall and increasing the presence of classical risk factors of atherosclerosis., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2024
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23. Growth Hormone, Atherosclerosis and Peripheral Arterial Disease: Exploring the Spectrum from Acromegaly to Growth Hormone Deficiency.
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Herman R, Janez A, Mikhailidis DP, Poredos P, Blinc A, Sabovic M, Studen KB, Schernthaner GH, Anagnostis P, Antignani PL, and Jensterle M
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- Humans, Growth Hormone physiology, Insulin-Like Growth Factor I metabolism, Acromegaly diagnosis, Acromegaly epidemiology, Acromegaly metabolism, Atherosclerosis diagnosis, Atherosclerosis epidemiology, Human Growth Hormone metabolism, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology
- Abstract
Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are increasingly recognised for their role in cardiovascular (CV) physiology. The GH-IGF-1 axis plays an essential role in the development of the CV system as well as in the complex molecular network that regulates cardiac and endothelial structure and function. A considerable correlation between GH levels and CV mortality exists even among individuals in the general population without a notable deviation in the GHIGF- 1 axis functioning. In addition, over the last decades, evidence has demonstrated that pathologic conditions involving the GH-IGF-1 axis, as seen in GH excess to GH deficiency, are associated with an increased risk for CV morbidity and mortality. A significant part of that risk can be attributed to several accompanying comorbidities. In both conditions, disease control is associated with a consistent improvement of CV risk factors, reduction of CV mortality, and achievement of standardised mortality ratio similar to that of the general population. Data on the prevalence of peripheral arterial disease in patients with acromegaly or growth hormone deficiency and the effects of GH and IGF-1 levels on the disease progression is limited. In this review, we will consider the pivotal role of the GH-IGF-1 axis on CV system function, as well as the far-reaching consequences that arise when disorders within this axis occur, particularly in relation to the atherosclerosis process., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2024
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24. Involvement of APOE in Incidence of Revascularization in Patients Affected by Peripheral Arterial Disease: A Prospective Study from Southern Italy.
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Di Stolfo G, Pacilli MA, Seripa D, De Luca G, Urbano M, Coli C, Gravina C, Greco A, Potenza DR, Salvatori MP, Schernthaner GH, Poredos P, Catalano M, and Mastroianno S
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Introduction: Atherosclerosis is a complex multifactorial disease and apolipoprotein E (APOE) polymorphism has been associated with cardiovascular events. The APOE gene, located on chromosome 19q13.2, has an important role in lipid metabolism, in particular on circulating cholesterol levels, implying further pleiotropic effects; from its polymorphism are derived three alleles (ε2, ε3 and ε4), which induce different phenotypes, while its impact on carotid and femoral atherosclerosis is still controversial., Objectives: The aim of the study is to investigate the relationship between APOE genotypes and peripheral revascularization in a cohort of patients affected by advanced peripheral arterial disease (PAD) at a prolonged follow-up., Materials and Methods: Some 332 patients (259 males and 73 females; mean age 70.86 ± 7.95 years) with severe PAD were enrolled in a longitudinal study, with a 90.75 ± 32.25 month follow-up, assessing major adverse cardiovascular events (MACE)., Results: As compared with ε3/ε3, in ε4 patients we observed a significant higher incidence of carotid (13.2% vs. 5.6%; HR = 2.485, 95% CI 1.062-5.814; p = 0.036) and lower limb (11.8% vs. 4.3%; HR = 2.765, 95% CI 1.091-7.008; p = 0.032) revascularizations and, accordingly, a higher incidence of total peripheral revascularizations (13.5% vs. 9.5%; HR = 2.705, 95% CI 1.420-5.151; p = 0.002). HR remained statistically significant even when adjusted for classic cardiovascular risk factors., Conclusions: In our observational study, we confirm that the ε4 allele is associated with higher total peripheral revascularization in patients with advanced atherosclerotic vascular disease at prolonged follow-up.
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- 2023
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25. The importance of socio-economic determinants of health in the care of patients with peripheral artery disease: A narrative review from VAS.
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Kolossváry E, Farkas K, Karahan O, Golledge J, Schernthaner GH, Karplus T, Bernardo JJ, Marschang S, Abola MT, Heinzmann M, Edmonds M, and Catalano M
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- Humans, Amputation, Surgical, Ethnicity, Socioeconomic Factors, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology, Peripheral Arterial Disease therapy
- Abstract
Socio-economic determinants of health (SDoH) include various nonmedical factors in the socio-economic sphere with a potentially significant impact on health outcomes. Their effects manifest through several mediators/moderators (behavioral characteristics, physical environment, psychosocial circumstances, access to care, and biological factors). Various critical covariates (age, gender/sex, race/ethnicity, culture/acculturation, and disability status) also interact. Analyzing the effects of these factors is challenging due to their enormous complexity. Although the significance of SDoH for cardiovascular diseases is well documented, research regarding their impact on peripheral artery disease (PAD) occurrence and care is less well documented. This narrative review explores to what extent SDoH are multifaceted in PAD and how they are associated with its occurrence and care. Additionally, methodological issues that may hamper this effort are addressed. Finally, the most important question, whether this association may contribute to reasonable interventions aimed at SDoH, is analyzed. This endeavor requires attention to the social context, a whole systems approach, multilevel-thinking, and a broader alliance that reaches out to more stakeholders outside the medical sphere. More research is needed to justify the power in this concept to improve PAD-related outcomes like lower extremity amputations. At the present time, some evidence, reasonable consideration, and intuitive reasoning support the implementation of various interventions in SDoH in this field.
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- 2023
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26. NT-proBNP as a surrogate for unknown heart failure and its predictive power for peripheral artery disease outcome and phenotype.
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Zierfuss B, Feldscher A, Höbaus C, Hannes A, Koppensteiner R, and Schernthaner GH
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- Humans, Prognosis, Biomarkers, Natriuretic Peptide, Brain, Peptide Fragments, Phenotype, Peripheral Arterial Disease diagnosis, Heart Failure
- Abstract
Patients with peripheral artery disease (PAD) are at high risk of excess mortality despite major improvements in multimodal pharmacotherapy for cardiovascular disease. However, little is known about co-prevalences and implications for the combination of heart failure (HF) and PAD. Thus, NT-proBNP as a suggested surrogate for HF was evaluated in symptomatic PAD regarding long-term mortality. After approval by the institutional ethics committee a total of 1028 patients with PAD, both with intermittent claudication or critical limb ischemia were included after admission for endovascular repair and were followed up for a median of 4.6 years. Survival information was obtained from central death database queries. During the observation period a total of 336 patients died (calculated annual death rate of 7.1%). NT-proBNP (per one standard deviation increase) was highly associated with outcome in the general cohort in crude (HR 1.86, 95%CI 1.73-2.01) and multivariable-adjusted Cox-regression analyses with all-cause mortality (HR 1.71, 95%CI 1.56-1.89) and CV mortality (HR 1.86, 95% CI 1.55-2.15). Similar HR's were found in patients with previously documented HF (HR 1.90, 95% CI 1.54-2.38) and without (HR 1.88, 95%CI 1.72-2.05). NT-proBNP levels were independently associated with below-the-knee lesions or multisite target lesions (OR 1.14, 95% CI 1.01-1.30). Our data indicate that increasing NT-proBNP levels are independently associated with long-term mortality in symptomatic PAD patients irrespective of a previously documented HF diagnosis. HF might thus be highly underreported in PAD, especially in patients with the need for below-the-knee revascularization., (© 2023. The Author(s).)
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- 2023
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27. Non-esterified fatty acids: Another piece in the puzzle of PAD risk stratification?
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Zierfuss B, Stangl H, and Schernthaner GH
- Subjects
- Risk Assessment, Fatty Acids, Fatty Acids, Nonesterified, Lipoproteins, HDL
- Published
- 2023
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28. Secondary calciprotein particle size is associated with patient mortality in peripheral artery disease.
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Bojic M, Cejka D, Bielesz B, Schernthaner GH, and Höbaus C
- Subjects
- Humans, Particle Size, Retrospective Studies, Sclerosis complications, Vascular Calcification etiology, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic complications, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease complications
- Abstract
Background and Aims: Secondary calciprotein particles (CPP-II) induce inflammation and contribute to vascular calcification. CPP-II size is associated with vascular calcification in patients with chronic kidney disease (CKD) and all-cause mortality in hemodialysis patients. Here, we investigate for the first time a possible role of CPP-II size in patients with peripheral artery disease (PAD) without severe CKD., Methods: We measured the hydrodynamic radius (Rh) of CPP-II by using dynamic light scattering in a cohort of 281 PAD patients. Mortality was evaluated over a period of ten years by central death registry queries. 35% of patients died during the observation period (median of 8.8 (6.2-9.0) years). Cox-regression analyses were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) and to allow for multivariable adjustment., Results: The mean CPP-II size was 188 (162-218) nm. Older patients, patients with reduced kidney function, and those with media sclerosis had larger CPP-II (p < 0.001, p = 0.008, and p = 0.043, retrospectively). There was no association between CPP-II size and overall atherosclerotic disease burden (p = 0.551). CPP-II size was independently significantly associated with all-cause (HR 1.33 (CI 1.01-1.74), p = 0.039) and cardiovascular mortality (HR 1.52 (CI 1.05-2.20), p = 0.026) in multivariable regression analyses., Conclusions: Large CPP-II size is associated with mortality in PAD patients and might be a new feasible biomarker for the presence of media sclerosis in this patient population., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
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29. The Effect of Menopause and Menopausal Hormone Therapy on the Risk of Peripheral Artery Disease.
- Author
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Anagnostis P, Mikhailidis DP, Blinc A, Jensterle M, Ježovnik MK, Schernthaner GH, Antignani PL, Studen KB, Šabović M, and Poredos P
- Subjects
- Female, Humans, Menopause, Risk Factors, Plaque, Atherosclerotic complications, Menopause, Premature, Primary Ovarian Insufficiency, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology, Peripheral Arterial Disease prevention & control, Atherosclerosis
- Abstract
Peripheral artery disease (PAD), defined as lower extremity arterial disease, constitutes an underestimated aspect of the menopause-associated risk of atherosclerotic cardiovascular disease (ASCVD). Accumulation of ASCVD risk factors, such as atherogenic dyslipidaemia, diabetes, and arterial hypertension, after the transition to menopause may contribute to atherosclerotic plaque formation in peripheral arteries. However, inconsistency exists among studies as to whether transition to menopause increases the risk of PAD, although early menopause (<45 years) or premature ovarian insufficiency may accelerate peripheral atherosclerotic plaque formation. Menopausal hormone therapy may decrease the risk of PAD if administered early ( i.e. , within the first 5-6 years after last menstruation), whereas it has no effect in women with established ASCVD., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2023
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30. Cardiometabolic Risk, Peripheral Arterial Disease and Cardiovascular Events in Polycystic Ovary Syndrome: Time to Implement Systematic Screening and Update the Management.
- Author
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Janez A, Herman R, Poredos P, Mikhailidis DP, Blinc A, Sabovic M, Studen KB, Jezovnik MK, Schernthaner GH, Anagnostis P, Antignani PL, and Jensterle M
- Subjects
- Female, Humans, Risk Factors, Polycystic Ovary Syndrome complications, Polycystic Ovary Syndrome diagnosis, Polycystic Ovary Syndrome epidemiology, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Hyperandrogenism, Insulin Resistance, Atherosclerosis, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology, Peripheral Arterial Disease therapy
- Abstract
Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder in women of reproductive age. It presents with gynaecologic, metabolic, and psychologic manifestations. The dominant drivers of pathophysiology are hyperandrogenism and insulin resistance. Both conditions are related to cardiometabolic risk factors, such as obesity, hypertension, dyslipidaemia, hyperglycaemia, type 2 and gestational diabetes, nonalcoholic fatty liver disease and obstructive sleep apnoea. Women with PCOS of reproductive age consistently demonstrated an elevated risk of subclinical atherosclerosis, as indicated by different measurement methods, while findings for menopausal age groups exhibited mixed results. Translation of subclinical atherosclerosis into the increased incidence of peripheral arterial disease and major cardiovascular (CV) events is less clear. Although several expert groups have advised screening, the CV risk assessment and prevention of CV events are frequently underdiagnosed and overlooked aspects of the management of PCOS. A combination of lifestyle management and pharmacotherapy, including the promising new era of anti-obesity medicine, can lead to improvements in cardiometabolic health., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2023
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31. [Individualising antihypertensive therapy in patients with diabetes. A guideline by the Austrian Diabetes Association (update 2023)].
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Saely CH, Schernthaner GH, Brix J, Klauser-Braun R, Zitt E, Drexel H, and Schernthaner G
- Subjects
- Humans, Antihypertensive Agents therapeutic use, Austria, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Blood Pressure, Angiotensin Receptor Antagonists therapeutic use, Hypertension drug therapy, Hypertension complications, Diabetes Mellitus drug therapy
- Abstract
Hypertension is one of the most important comorbidities of diabetes, contributing significantly to death and leading to macrovascular and microvascular complications. When assessing the medical priorities for patients with diabetes, treating hypertension should be a primary consideration. In the present review practical approaches to hypertension in diabetes, including individualized targets for preventing specific complications are discussed according to current evidence and guidelines. Blood pressure values of about 130/80 mm Hg are associated with the best outcome; most importantly, at least blood pressure values < 140/90 mm Hg should be achieved in most patients. Angiotensin converting enzyme inhibitors or angiotensin receptor blockers should be preferred in patients with diabetes, especially in those who also have albuminuria or coronary artery disease. Most patients with diabetes require combination therapy to achieve blood pressure goals; agents with proven cardiovascular benefit should be used (including, besides angiotensin converting enzyme inhibitors and alternatively angiotensin receptor blockers, dihydropyridin-calcium antagonists and thiazide diuretics), preferable in single-pill combinations. Once the target is achieved, antihypertensive drugs should be continued. Newer antidiabetic medications such as SGLT-2-inhibitors or GLP1-receptor agonists have also antihypertensive effects., (© 2023. The Author(s).)
- Published
- 2023
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32. Testosterone and Peripheral Arterial Disease.
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Blinc A, Schernthaner GH, Poredoš P, Anagnostis P, Jensterle M, Studen KB, Antignani PL, Mikhailidis DP, and Šabović M
- Subjects
- Male, Humans, Adult, Testosterone adverse effects, Androgen Antagonists, Obesity complications, Hypogonadism diagnosis, Hypogonadism drug therapy, Hypogonadism complications, Prostatic Neoplasms complications, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease drug therapy
- Abstract
Testosterone levels in men begin declining in the early years of adulthood, with a 1-2% reduction/year. Low testosterone levels in men are associated with obesity, metabolic syndrome, diabetes mellitus, dyslipidaemia, hypertension and increased cardiovascular mortality. However, observational studies of testosterone levels in males and their relationship with peripheral arterial disease (PAD) have yielded mixed results; only some cohorts show a clear association with low free testosterone levels. This discrepancy may, in part, be due to methodological issues with estimating free testosterone but also to different effects of testosterone on the vessel wall and metabolism. While testosterone improves glycaemic control, has anti-obesity effects and induces vasodilation, it also stimulates platelet aggregation and increases the haematocrit. Androgen deprivation treatment for advanced prostate cancer may be associated with elevated cardiovascular risk, as is testosterone abuse for performance enhancement. On the other hand, judicious treatment of male hypogonadism or testosterone treatment of trans-men appears to be safe., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2023
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33. Lipoprotein (a) and long-term outcome in patients with peripheral artery disease undergoing revascularization.
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Zierfuss B, Höbaus C, Feldscher A, Hannes A, Mrak D, Koppensteiner R, Stangl H, and Schernthaner GH
- Subjects
- Humans, Lipoprotein(a), Intermittent Claudication diagnosis, Intermittent Claudication surgery, Risk Factors, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease surgery, Coronary Artery Disease
- Abstract
Background and Aims: Despite low LDL-C goals, the residual risk for further cardiovascular (CV) events in patients with peripheral artery disease (PAD) remains high. Lipoprotein (a) (Lp(a)) is a known risk factor for PAD incidence, but little is known regarding the outcome in patients with symptomatic PAD. Thus, this study investigates Lp(a) and CV mortality in PAD after endovascular repair., Methods: A total of 1222 patients with PAD in two cohorts according to Lp(a) assay in nmol/L (n = 964, Lip-LEAD-A) or mg/dl (n = 258, Lip-LEAD-B) were followed up for 4.3 (IQR 3.0-5.6) or 7.6 (IQR 3.2-8.1) years. Lp(a) was measured before endovascular repair for either intermittent claudication (IC) or critical limb ischemia (CLI). Outcome information was obtained from the federal death registry., Results: In Lip-LEAD-A, 141 CV-deaths occurred (annual calculated CV-death rate 3.4%), whereas 64 CV-deaths were registered in Lip-LEAD-B (annual calculated CV-death rate 3.3%). After adjustment for traditional CV risk factors Lp(a) was neither associated with outcome in Lip-LEAD-A (highest tertile HR 1.47, 95%CI [0.96-2.24]) nor in Lip-LEAD-B (highest tertile HR 1.34 [0.70-2.58]). Subanalyses for IC (HR 1.37 [0.74-2.55]; HR 1.10 [0.44-2.80], CLI (HR 1.55 [0.86-2.80], HR 3.01 [0.99-9.10]), or concomitant coronary artery disease (CAD; HR 1.34 [0.71-2.54]; HR 1.21 [0.46-3.17]) failed to show a significant association between Lp(a) and CV-mortality., Conclusions: In this large-scale cohort of symptomatic PAD no association of elevated Lp(a) with CV mortality was found over a median observation period of 5 years. Thus, an even longer study including asymptomatic patients is warranted., Competing Interests: Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
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34. High-Density Lipoprotein Particle Subclasses in Statin-Treated Patients with Peripheral Artery Disease Predict Long-Term Survival.
- Author
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Zierfuss B, Höbaus C, Herz CT, Koppensteiner R, Stangl H, and Schernthaner GH
- Subjects
- Cholesterol, HDL, Humans, Lipoproteins, Lipoproteins, LDL, Risk Factors, Cardiovascular Diseases, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease drug therapy
- Abstract
Low-density lipoprotein-cholesterol reduction showed a strong reduction of cardiovascular (CV) event rates in CV disease. However, the residual risk of future CV events remains high, which especially extends to peripheral arterial disease (PAD). Nuclear magnetic resonance (NMR) spectroscopy offers a novel method for analysis of the lipoprotein spectrum. This study investigates lipoprotein subclasses using NMR spectroscopy and assesses implications for long-term survival in PAD. NMR spectroscopy was performed by Nightingale Inc., in 319 patients with stable PAD and well-controlled CV risk factors. Patients were followed-up for 10 years. During that period, 123 patients (38.5%) died, of those 68 (21.3%) were defined as CV deaths. Outcome data were analyzed by the Kaplan-Meier method and multivariable Cox-regression for lipoprotein particles. Small and medium high-density lipoprotein-particles (S-HDL-P and M-HDL-P) showed a significant inverse association with all-cause mortality in Cox-regression analyses after multivariable adjustment (S-HDL-P, hazard ratio [HR]: 0.71, 95% confidence interval [CI]: 0.57-0.88; M-HDL-P, HR: 0.72, 95% CI: 0.58-0.90) for each increase of one standard deviation. In contrast, cholesterol-rich X-large HDL-particles (XL-HDL-P) showed a positive association with all-cause mortality (HR: 1.51, 95% CI: 1.20-1.89). Only the association between XL-HDL-P and CV death sustained multivariable adjustment (HR: 1.49, 95% CI: 1.10-2.02), whereas associations for S-HDL-P and M-HDL-P were attenuated (HR: 0.76, 95% CI: 0.57-1.01; HR: 0.80, 95% CI: 0.60-1.06). This study shows a novel association for a beneficial role of S-HDL-P and M-HDL-P but a negative association with higher cholesterol-rich XL-HDL-P for long-term outcome in well-treated patients with PAD. Thus, these results provide evidence that NMR-measured HDL particles identify patients at high CV residual risk beyond adequate lipid-lowering therapy., Competing Interests: None declared., (Thieme. All rights reserved.)
- Published
- 2022
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35. UEMS Training Requirements for Angiology/Vascular Medicine: European Standards of Postgraduate Medical Specialist Training (2022 Updated Version).
- Author
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Wautrecht JC, Olinic DM, Catalano M, Baines C, Belch J, Blinc A, Buschmann I, Celovska D, Colgan MP, Dimakakos E, Heiss C, Kolossvary E, Kozak M, Kroon B, Mazzolai L, Marakomichelakis G, Pecsvarady Z, Pias Canedo MA, Quere I, Roztocil K, Schernthaner GH, Sieron A, Spaak J, Sprynger M, Stanek A, Staub D, Vasic D, Visona A, and Willfort-Ehringer A
- Subjects
- Curriculum, Education, Medical, Graduate, Europe, Humans, Specialization, Cardiology
- Published
- 2022
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- View/download PDF
36. Calcification Propensity in Serum and Cardiovascular Outcome in Peripheral Artery Disease.
- Author
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Bojic M, Bielesz B, Cejka D, Schernthaner GH, and Höbaus C
- Subjects
- Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Calcinosis epidemiology, Peripheral Arterial Disease complications, Peripheral Arterial Disease diagnosis, Renal Insufficiency, Chronic
- Abstract
Peripheral artery disease (PAD) has been shown to be linked to elevated cardiovascular risk. The novel T
50 test quantifies calcification propensity of serum and has been associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD) and in the general population. This study investigated the association of calcification propensity measured by the T50 test in 287 patients with PAD without severe CKD. Major cardiovascular events (MACEs) including nonfatal stroke and nonfatal myocardial infarction and all-cause death (MACE + ) were evaluated after a median follow-up of 4 years and long-term cardiovascular and all-cause mortality after a median follow-up of 8.7 years by Kaplan-Meier and Cox regression analyses. Mean T50 time was 268 ± 63 minutes in the study cohort (age 69 ± 10 years, 32% women, 47% diabetes). Low T50 values that signify high calcification propensity were significantly associated with the occurrence of MACE+ (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.55-0.94). This association sustained multivariate adjustment for cardiovascular risk factors (CVRFs), Fontaine PAD stage, and prevalent media sclerosis (HR: 0.65; CI: 0.47-0.91). Cardiovascular mortality was significantly associated with T50 after multivariate adjustment for CVRF (HR: 0.72; CI 0.53-0.99), but not all-cause mortality (HR: 0.80; CI: 0.64-1.01). In conclusion, calcification propensity associates with MACE+ and cardiovascular mortality in patients with PAD., Competing Interests: None declared., (Thieme. All rights reserved.)- Published
- 2022
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37. Preclinical atherosclerosis and cardiovascular events: Do we have a consensus about the role of preclinical atherosclerosis in the prediction of cardiovascular events?
- Author
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Poredoš P, Cífková R, Marie Maier JA, Nemcsik J, Šabovič M, Jug B, Ježovnik MK, Schernthaner GH, Antignani PL, Catalano M, Fras Z, Höbaus C, Nicolaides AN, Paraskevas KI, Reiner Ž, Wohlfahrt P, Poredoš P, and Blinc A
- Subjects
- Carotid Arteries diagnostic imaging, Carotid Intima-Media Thickness, Consensus, Humans, Pulse Wave Analysis, Risk Factors, Atherosclerosis diagnosis, Cardiovascular Diseases diagnosis
- Abstract
Atherosclerosis has a long preclinical phase, and the risk of cardiovascular (CV) events may be high in asymptomatic subjects. Conventional risk factors provide information for the statistical probability of developing CV events, but they lack precision in asymptomatic subjects. This review aims to summarize the role of some widely publicized indicators of early atherosclerosis in predicting CV events. The earliest measurable indicator of the atherosclerotic process is endothelial dysfunction, measured by flow-mediated dilation (FMD) of the brachial artery. However, reduced FMD is a stronger predictor of future CV events in patients with existing CV disease than in apparently healthy persons. Alternatively, measurement of carotid artery intima-media thickness does not improve the predictive value of risk factor scores, while detection of asymptomatic atherosclerotic plaques in carotid or common femoral arteries by ultrasound indicates high CV risk. Coronary calcium is a robust and validated help in the estimation of vascular changes and risk, which may improve risk stratification beyond traditional risk factors with relatively low radiation exposure. Arterial stiffness of the aorta, measured as the carotid-femoral pulse wave velocity is an independent marker of CV risk at the population level, but it is not recommended as a routine procedure because of measurement difficulties. Low ankle-brachial index (ABI) indicates flow-limiting atherosclerosis in the lower limbs and indicates high CV risk, while normal ABI does not rule out advanced asymptomatic atherosclerosis. Novel circulating biomarkers are associated with the atherosclerotic process. However, because of limited specificity, their ability to improve risk classification at present remains low., (Copyright © 2022. Published by Elsevier B.V.)
- Published
- 2022
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38. Galectin-3 is linked to peripheral artery disease severity, and urinary excretion is associated with long-term mortality.
- Author
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Ursli M, Zierfuss B, Grigassy T, Pesau G, Koppensteiner R, Schernthaner GH, and Höbaus C
- Subjects
- Aged, Blood Proteins, Chronic Limb-Threatening Ischemia, Galectins, Glomerular Filtration Rate, Humans, Risk Factors, Galectin 3, Peripheral Arterial Disease diagnosis
- Abstract
Background and Aims: Galectin-3 (Gal-3) is a biomarker involved in fibrosis and vascular inflammation. Gal-3 has been linked to chronic kidney disease (CKD) and patients with peripheral artery disease (PAD). Conflicting reports exist about the relevance of Gal-3 in PAD. The study aims to elucidate a possible link between serum and urinary Gal-3 and long-term survival in PAD patients without critical limb ischemia and mild to moderate CKD., Methods: Galectin-3 (Gal-3) was measured in serum (n = 311) and urine (n = 266) of PAD patients (age 69 (62-77) years) by bead-based multiplex assay. Urinary Gal-3 concentration was normalized to urine creatinine (cr) levels. Mortality data were retrieved from the Austrian central death registry after a median observation period of 9.2 years. Survival analyses were performed by the Kaplan-Meier method and Cox-regression., Results: Serum Gal-3 was higher in patients with claudication symptoms (p = 0.001) and correlated inversely with the patients' ankle-brachial index (R = -0.168, p = 0.009). Serum Gal-3 and urinary Gal-3 (uGal-3/cr) were associated with the estimated glomerular filtration rate (R = -0.359, p < 0.001; R = -0.285, p < 0.001). Serum Gal-3 was not linked to all-cause mortality [HR 1.17 (CI 0.96-1.42)] over 9.2 years. However, uGal-3/cr was associated with all-cause mortality [HR 1.60 (CI 1.31-1.95)]. This association sustained multivariable adjustment for cardiovascular risk factors and renal function [HR 1.71 (CI 1.35-2.17)]., Conclusions: This study is the first to show an association of uGal-3/cr and long-term mortality in patients with PAD. Gal-3 was not predictive of long-term mortality but seems to be a marker of PAD severity in patients without critical limb ischemia., (Copyright © 2021. Published by Elsevier B.V.)
- Published
- 2022
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39. Statin initiation in dialysis patients: The hardship of non-prescription.
- Author
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Hecking M, Karaboyas A, Schernthaner GH, and Wanner C
- Subjects
- Humans, Renal Dialysis, Retrospective Studies, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects
- Published
- 2021
- Full Text
- View/download PDF
40. Angiogenin-A Proposed Biomarker for Cardiovascular Disease-Is Not Associated With Long-Term Survival in Patients With Peripheral Artery Disease.
- Author
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Höbaus C, Pesau G, Zierfuss B, Koppensteiner R, and Schernthaner GH
- Subjects
- Aged, Aged, 80 and over, Biomarkers blood, Cross-Sectional Studies, Enzyme-Linked Immunosorbent Assay, Female, Humans, Intermittent Claudication diagnosis, Intermittent Claudication mortality, Male, Middle Aged, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease mortality, Pilot Projects, Predictive Value of Tests, Prognosis, Time Factors, Intermittent Claudication blood, Peripheral Arterial Disease blood, Ribonuclease, Pancreatic blood
- Abstract
We evaluated angiogenin as a prospective biomarker in peripheral artery disease (PAD) patients with and without claudication symptoms. A pilot study suggested an elevation of angiogenin in critical limb ischemia. However, in PAD patients, the predictive value of angiogenin has not yet been evaluated. For this purpose, 342 patients with PAD (age: 69 ± 10 years, 34.5% women) were followed-up for 7 years in a cross-sectional study. Angiogenin was measured by enzyme-linked immunosorbent assay. All-cause and cardiovascular mortality were analyzed by Cox regression. Angiogenin levels were higher in men ( P = .001) and were associated with patient waist-to-hip ratio ( P < .001), fasting triglycerides ( P = .011), and inversely with estimated glomerular filtration rate ( P = .009). However, angiogenin showed no association with age, characteristics of diabetes, markers of lipid metabolism, or C-reactive protein. Angiogenin did not correlate with markers of angiogenesis such as vascular endothelial growth factor, angiopoietin-2, or tie-2. Furthermore, angiogenin was not associated with PAD Fontaine stages or with patient ankle-brachial index in addition to all-cause mortality (hazard ratio [HR] = 1.09 [95% CI: 0.89-1.34]) or cardiovascular morality (HR = 1.05 [0.82-1.35]). These results suggest that angiogenin does not provide further information regarding outcome prediction in patients with PAD.
- Published
- 2021
- Full Text
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41. Peripheral artery disease and depression: Prerequisites for a lose-lose situation?
- Author
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Zierfuss B, Norgren L, and Schernthaner GH
- Subjects
- Depression diagnosis, Depression epidemiology, Humans, Risk Factors, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology
- Published
- 2021
- Full Text
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42. Decrease of dipeptidyl peptidase 4 activity is associated with weight loss after bariatric surgery.
- Author
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Herz CT, Brix JM, Ludvik B, Schernthaner G, and Schernthaner GH
- Subjects
- Humans, Insulin Resistance, Bariatric Surgery, Dipeptidyl Peptidase 4, Obesity, Morbid surgery, Weight Loss
- Abstract
Purpose: Dipeptidyl peptidase 4 (DPP4) is expressed and secreted by adipocytes. DPP4 induces insulin resistance independently of its effect on glucagon-like peptide 1, thus it is conceivable that DPP4 directly contributes to metabolic dysfunction in patients with morbid obesity. The aim of this study was to investigate the impact of weight loss induced by bariatric surgery on DPP4 activity, and whether these changes are associated with improvements in markers of metabolic dysfunction and fatty liver disease., Materials and Methods: We included 68 non-diabetic patients who underwent bariatric surgery. Serum DPP4 activity was measured using a fluorogenic substrate before and after surgery., Results: Results: After a median follow-up period of 12 (IQR 11-17) months, median serum DPP4 activity decreased from 230 (IQR: 194-273) to 193 (164-252) pmol/min (p=0.012). The decrease in DPP4 activity was significantly correlated with decreases in BMI, improved cholesterol levels, reduced hepatic injury markers as well as improved post-prandial insulin sensitivity. After multivariable adjustment, ΔDPP4 activity remained significantly associated with Δcholesterol (beta=0.341, p=0.025), ΔLDL cholesterol (beta=0.350, p=0.019), Δgamma-glutamyltransferase (beta=0.323, p=0.040) and ΔMatsuda index (beta=-0.386, p=0.045)., Conclusion: We demonstrated that weight loss induced by bariatric surgery results in decreased circulating DPP4 activity beyond the initial phase of weight loss. The associations between decreased DPP4 activity and improved cholesterol levels as well as hepatic injury markers point towards pleiotropic effects of DPP4 beyond glucose metabolism which warrant further investigation.
- Published
- 2021
- Full Text
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43. Vascular peroxidase 1 is independently associated with worse kidney function in patients with peripheral artery disease.
- Author
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Costas L, Herz CT, Höbaus C, Koppensteiner R, and Schernthaner GH
- Subjects
- Albuminuria diagnosis, Cross-Sectional Studies, Glomerular Filtration Rate, Humans, Kidney, Peroxidases, Peripheral Arterial Disease diagnosis, Renal Insufficiency, Chronic diagnosis
- Abstract
Background: Oxidative stress is involved in cardiovascular disease such as peripheral artery disease (PAD). Vascular Peroxidase 1 (VPO1), a novel heme-containing peroxidase mainly expressed in the cardiovascular system, aggravates oxidative stress. Evidence in humans is limited. Current work aims to measure VPO1 in patients suffering from PAD, and to evaluate the association of VPO1 with conventional markers of cardiovascular risk factors (CVRF), including the estimated glomerular filtration rate (eGFR) and albuminuria categories., Methods: This study is part of a longitudinal observational study. At baseline, 236 PAD-patients were included. VPO1 plasma levels (ng/mL) were measured by commercially available ELISA kits. A two-sided p level of < 0.05 was considered statistically significant., Results: In the cross-sectional analysis (n = 236), VPO1 associated with ageing (p = 0.035) as well as with eGFR and albuminuria category, the markers of chronic kidney disease (CKD)-progression (p = 0.042). The longitudinal 18-months follow-up analysis (n = 152) demonstrated that baseline VPO1 predicts rapid kidney function decline (RKFD) (n = 49), defined as more than - 3 mL/min/1.73m
2 eGFR loss per year, (OR per one SD VPO1 1.60 (1.11-2.30); p = 0.009). This association between VPO1 and kidney function withstood the multivariable adjustment for traditional CVRF including baseline eGFR and urine albumin-to-creatinine ratio (UACR), (adjOR per one SD VPO1 1.73 (1.14-2.61); p = 0.046)., Conclusion: This study is first to reveal that VPO1 is independently associated with declining kidney function in patients with PAD. VPO1 shows a tighter association to kidney function than to other CVRF. This finding points to VPO1 as a potential target protein to assess CKD-progression.- Published
- 2021
- Full Text
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44. Soluble urokinase-type plasminogen activator receptor predicts peripheral artery disease severity and outcomes.
- Author
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Höbaus C, Ursli M, Yussef SM, Wrba T, Koppensteiner R, and Schernthaner GH
- Subjects
- Aged, Biomarkers, ErbB Receptors, Female, Humans, Kidney, Male, Middle Aged, Patient Acuity, Receptors, Urokinase Plasminogen Activator, Renal Insufficiency, Chronic diagnosis, Peripheral Arterial Disease diagnosis
- Abstract
Soluble urokinase-type plasminogen activator receptor (suPAR) is associated with chronic kidney disease (CKD) severity and peripheral artery disease (PAD). We hypothesize an association of PAD severity and suPAR in patients without advanced CKD and further risk stratification according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. For study purposes, suPAR was measured in 334 PAD patients (34% women, age 69 (62-78) years, eGFR 68 ± 20 mL/min/1.72 m
2 ) by commercial ELISA. Patients were followed for 10 years to assess long-term all-cause survival by Cox regression. Higher suPAR levels were associated with lower ankle-brachial index ( R = -0.215, p = 0.001) in patients with PAD without media-sclerosis ( n = 236). suPAR levels inversely correlated with decreased glomerular filtration rate ( R = -0.476, p < 0.001) and directly correlated with urinary albumin-to-creatinine ratio ( R = 0.207, p < 0.001). Furthermore, higher suPAR levels associated with a higher KDIGO risk score ( p < 0.001). Baseline suPAR was significantly associated with all-cause mortality (HR 1.40 (95% CI 1.16-1.68), p < 0.001) over 10 years. suPAR remained associated with mortality (HR 1.29 (1.03-1.61), p = 0.026) after multivariable adjustment for age, sex, cardiovascular risk factors, and eGFR. Future research may define a standard role for suPAR assessment in PAD's work-up and treatment, especially in patients with CKD.- Published
- 2021
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45. Evaluation of sCD163 and sTWEAK in patients with stable peripheral arterial disease and association with disease severity as well as long-term mortality.
- Author
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Mrak D, Zierfuss B, Höbaus C, Herz CT, Pesau G, and Schernthaner GH
- Subjects
- Antigens, CD, Antigens, Differentiation, Myelomonocytic, Biomarkers, Cytokine TWEAK, Humans, Receptors, Cell Surface, Risk Factors, Severity of Illness Index, Tumor Necrosis Factors, Peripheral Arterial Disease diagnosis
- Abstract
Background and Aims: The TNF-superfamily member sTWEAK and its scavenger receptor sCD163 are potentially involved in pathophysiological processes of atherosclerosis. In patients with peripheral arterial disease, previous research has shown that sTWEAK and the sCD163/sTWEAK ratio were independently associated with long term all-cause and cardiovascular survival. Since previous investigations emphasized on symptomatic peripheral arterial disease including critical limb ischemia, this study evaluates sTWEAK and sCD163 in a cohort of stable peripheral arterial disease including asymptomatic (Fontaine stage I) and intermittent claudication (Fontaine stage II) patients., Methods: sTWEAK concentrations of 354 patients were measured using a commercially available ELISA kit. sCD163 was quantified using a multiplex bead assay. Cox proportional hazards regression was used to assess outcome after a seven-year follow-up. Hazard ratios are given as interquartile range., Results: Patients with intermittent claudication exhibited increased sCD163 levels in comparison to asymptomatic patients (p = 0.002). However, sTWEAK was not related to peripheral arterial disease severity (p = 0.740). A multivariable Cox-proportional hazard models including sTWEAK and cardiovascular risk factors (age, HbA1c, CRP, LDL-C, BMI, eGFR) revealed an inverse association with all-cause mortality (HR 0.775 (95% CI 0.623-0.965) and cardiovascular mortality (HR 0.710 (95% CI 0.534-0.944)). Further multivariable models including sCD163 or the sCD163/sTWEAK ratio and cardiovascular risk factors showed no association with mortality., Conclusions: This study highlights the use of sCD163 as a novel biomarker for PAD severity and supports sTWEAK as an independent predictor of all-cause and cardiovascular mortality even in stable peripheral arterial disease., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
- Full Text
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46. GlycA for long-term outcome in T2DM secondary prevention.
- Author
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Zierfuss B, Höbaus C, Herz CT, Pesau G, Mrak D, Koppensteiner R, and Schernthaner GH
- Subjects
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diabetes Mellitus, Type 2 mortality, Female, Glycosylation, Humans, Male, Middle Aged, Peripheral Arterial Disease etiology, Survival Analysis, Biomarkers blood, Diabetes Mellitus, Type 2 prevention & control, Magnetic Resonance Spectroscopy methods, Peripheral Arterial Disease diagnosis, Secondary Prevention methods
- Abstract
Aims: Glycosylated acetyls (GlycA), a systemic marker of inflammation, were associated both with incident type 2 diabetes mellitus (T2DM) and incident cardiovascular (CV) disease. This study evaluates the predictive value of GlycA for long-term survival in patients with T2DM and peripheral artery disease (PAD)., Methods: GlycA (mmol/l) levels were measured by nuclear magnetic resonance spectroscopy in a cross-sectional cohort of patients with PAD (n = 319). Both all-cause and CV mortality were evaluated after a follow-up of 9.0 (IQR 6.5-9.5) years. During the follow-up 117 patients died, of those 64 events were of CV origin (PAD-T2DM subgroup: all-cause mortality n = 60, CV-mortality n = 32)., Results: PAD-T2DM showed a tendency towards a worse CV risk factor profile and a higher percentage of known coronary artery disease (24.9% vs 43.5%, p < 0.001). GlycA levels were higher in PAD-T2DM (1.6 ± 0.2 vs. 1.53 ± 0.18, p = 0.002). GlycA predicted all-cause mortality after multivariable adjustment for traditional CV risk factors (HR for 1 SD increase 1.51, 95% confidence interval 1.03-2.19) in PAD-T2DM, while no association could be seen with CV-mortality (1.22, 0.73-2.06)., Conclusions: GlycA was capable of predicting long-term outcome in PAD patients with T2DM. Thus, GlycA might reflect the added inflammatory burden of T2DM in systemic atherosclerosis., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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47. The enigma to best screen, evaluate and diagnose peripheral artery disease.
- Author
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Seinost G, HÖbaus C, and Schernthaner GH
- Subjects
- Ankle Brachial Index, Humans, Lower Extremity, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology
- Published
- 2020
- Full Text
- View/download PDF
48. New horizons for mortality risk stratification in PAD: Are targeted multiplex proteomics the next step?
- Author
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Zierfuss B, Neumayer C, and Schernthaner GH
- Subjects
- Follow-Up Studies, Humans, Outpatients, Proteomics, Risk Assessment, Risk Factors, Peripheral Arterial Disease
- Published
- 2020
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49. The peripheral perfusion between two extremes: Is a fraction of the pulse wave enough information?
- Author
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Zierfuss B, Schernthaner GH, and Höbaus C
- Subjects
- Brachial Artery, Heart Rate, Humans, Pulse Wave Analysis, Ankle Brachial Index, Cardiovascular Diseases
- Abstract
Competing Interests: Declaration of competing interest The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript.
- Published
- 2020
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50. Predictive power of novel and established obesity indices for outcome in PAD during a five-year follow-up.
- Author
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Zierfuss B, Höbaus C, Herz CT, Pesau G, Koppensteiner R, and Schernthaner GH
- Subjects
- Adiposity, Adult, Aged, Aged, 80 and over, Body Mass Index, Cause of Death, Female, Humans, Male, Middle Aged, Obesity mortality, Obesity physiopathology, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease physiopathology, Peripheral Arterial Disease therapy, Predictive Value of Tests, Prognosis, Registries, Risk Assessment, Risk Factors, Time Factors, Waist Circumference, Waist-Hip Ratio, Anthropometry, Obesity diagnosis, Peripheral Arterial Disease mortality
- Abstract
Background and Aims: Previous data show contradicting results regarding relevance of obesity on outcome in peripheral arterial disease (PAD). Thus, this study aims to evaluate the predictive power of obesity as measured by established and novel obesity indices (waist circumference WC, waist-hip ratio WHR, body-mass index BMI, body adiposity index BAI, visceral adiposity index VAI, weight-adjusted waist index WWI) in a PAD cohort., Methods and Results: In 367 patients with diagnosed PAD anthropometric parameters were assessed at study inclusion in an observational study. Mortality data was retrieved from the central death registry after five years. Outcome analyses were performed by multivariable Cox-regression models. 57 PAD patients (15.5%) died during the follow-up, of those 36 were categorized as cardiovascular origin. Patients from the all-cause mortality group were older, more often diabetics with a worse glucose control and had worse renal function. Obesity indices were not significantly different between the event and control group. None of the evaluated risk factors predicted cardiovascular or all-cause death after multivariable adjustment for age, gender, LDL-C, serum creatinine, systolic blood pressure, CRP, smoking habits, diabetes status and previous history of peripheral revascularisation (all-cause WC 1.007 (0.983-1.031), WHR 1.772 (0.106-29.595), BMI 1.006 (0.939-1.078), BAI 1.002 (0.945-1.063), VAI 1.019 (0.895-1.161), WWI 1.085 (0.831-1.416); cv-death WC 1.007 (0.978-1.036), WHR 0.382 (0.006-25.338), BMI 1.004 (0.918-1.098), BAI 1.034 (0.959-1.116), VAI 1.036 (0.885-1.213), WWI 1.061 (0.782-1.441))., Conclusion: Obesity as risk marker estimated by indices both for general and visceral adiposity, does not predict mortality in a secondary prevention cohort of PAD patients., Competing Interests: Declaration of Competing Interest There are no potential conflicts of interest to declare. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors., (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
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