Statin therapy and long-term adverse limb outcomes in patients with peripheral artery disease: insights from the REACH registry

Aims Due to a high burden of systemic cardiovascular events, current guidelines recommend the use of statins in all patients with peripheral artery disease (PAD). We sought to study the impact of statin use on limb prognosis in patients with symptomatic PAD enrolled in the international REACH registry. Methods Statin use was assessed at study enrolment, as well as a time-varying covariate. Rates of the primary adverse limb outcome (worsening claudication/new episode of critical limb ischaemia, new percutaneous/surgical revascularization, or amputation) at 4 years and the composite of cardiovascular death/myocardial infarction/stroke were compared among statin users vs. non-users. Results A total of 5861 patients with symptomatic PAD were included. Statin use at baseline was 62.2%. Patients who were on statins had a significantly lower risk of the primary adverse limb outcome at 4 years when compared with those who were not taking statins [22.0 vs. 26.2%; hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.72–0.92; P = 0.0013]. Results were similar when statin use was considered as a time-dependent variable (P = 0.018) and on propensity analysis (P
Source: European Heart Journal - Category: Cardiology Authors: Tags: Vascular medicine Source Type: research

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ABSTRACT: Introduction: In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. Objective: To evaluate the association between family income and cardiovascular risk factors in young adults. Methods: A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeir ão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)...
Source: Revista Brasileira de Epidemiologia - Category: Epidemiology Source Type: research
Conclusions Preoperative serum TC level is an independent poor prognostic factor for patients with surgically treated RCC, with lower levels associated with worse CSS and PFS. Hence, this parameter may provide additional guidance in the selection of therapeutic strategies to improve prognosis, considering that cholesterol is a broadly applied routine marker in clinical practice.
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
Conclusions: In the search for more effective and less invasive therapies to help reverse the global acceleration of obesity and obesity-related disease OEA is a promising candidate; however, our data indicate that it is not an underlying mechanism of the effectiveness of VSG.
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research
Each day comes with its own challenges. For that matter, each week, month, and year does as well. Those challenges and other stressful events will vary in intensity and their affect upon our lives, but too often they can become overly consuming and distracting, leaving us anxious and seeing only the negative. In order to manage the problems that life can throw at us we are often told to “Keep things in perspective,” and not to “sweat the small stuff.” But sometimes it really is the small stuff that matters. In fact, making time to notice and appreciate the small things can make a big difference in y...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Anger Anxiety and Panic Mindfulness Source Type: blogs
ConclusionOur findings suggest that consumption of a cafeteria diet increases sympathetic drive to the heart but not to the blood vessels, independent of impairment in baroreflex and chemoreflex functions. Other mechanisms may be involved in the increased cardiac sympathetic drive, and compensatory vascular mechanisms may prevent the development of hypertension in this model of obesity.
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
Publication date: Available online 21 February 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Andrea Demarchi, Iolanda Mazzucchelli, Alberto Somaschini, Stefano Cornara, Veronica Dusi, Alessandro Mandurino Mirizzi, Marta Ruffinazzi, Gabriele Crimi, Marco Ferlini, Massimiliano Gnecchi, Luigi Oltrona Visconti, Stefano De Servi, Gaetano M. De FerrariAbstractLeptin is an adipose tissue-derived hormone primarily involved in the regulation of food intake. Leptine has been shown to have a much broader role than just regulating body weight and appetite in response to food intake: among the others, it has b...
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
This study aimed to investigate the effects of rTPA in WUS patients during every day clinical scenarios, by measuring ischemic lesion volume and functional outcomes compared to non-treated WUS patients.MethodsWe retrospectively analyzed clinical and imaging data of 149 (75  rTPA; 74 non-rTPA) patients with acute ischemic WUS. Ischemic volume was calculated on follow-up CT and functional outcomes were the NIHSS and mRS comparing rTPA and non-rTPA WUS. Patients were selected using ASPECTS >  6 on CT and/or ischemic penumbra >  50% of hypoperfused tissue on CTP.ResultsA reduced volu...
Source: Journal of Neurology - Category: Neurology Source Type: research
Conditions:   Ischemic Stroke;   Adipose Tissue-derived Stem Cell;   Functional Status Interventions:   Other: Alogenic adipose tissue-derived stem cells;   Drug: Placebo solution Sponsor:   Instituto de Investigación Hospital Universitario La Paz Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Stroke Intervention:   Sponsor:   University of Utah Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Campaigners fighting a regional centralisation of stroke services have lost their judicial review.
Source: HSJ - Category: UK Health Source Type: news
More News: Cardiology | Cardiovascular | Cholesterol | Heart | Heart Attack | Intermittent Claudication | Ischemic Stroke | Peripheral Vascular Disease (PVD) | Statin Therapy | Stroke | Study