Department Of Vascular Medicine Research Articles

Effect of PCSK9 Inhibition on the Plasma Proteome: A SPIRE SubStudy.

HomeArteriosclerosis, Thrombosis, and Vascular BiologyAhead of PrintEffect of PCSK9 Inhibition on the Plasma Proteome: A SPIRE SubStudy Open AccessResearch ArticlePDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toOpen AccessResearch ArticlePDF/EPUBEffect of PCSK9 Inhibition on the Plasma Proteome: A SPIRE SubStudy Jordan M. Kraaijenhof, Tjerk S.J. Opstal, Jan H. Cornel, Dipender Gill, G. Kees Hovingh, Alberico L. Catapano, Wolfgang Koenig, Paul M Ridker, Erik S.G. Stroes and Nick S. Nurmohamed Jordan M. KraaijenhofJordan M. Kraaijenhof https://orcid.org/0000-0001-7566-6403 Department of Vascular Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands (J.M.K., G.K.H., E.S.G.S., N.S.N.). Search for more papers by this author , Tjerk S.J. OpstalTjerk S.J. Opstal https://orcid.org/0000-0003-3654-0327 Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands (T.S.J.O., J.H.C.). Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands (T.S.J.O., J.H.C.). Search for more papers by this author , Jan H. CornelJan H. Cornel https://orcid.org/0000-0002-1006-2112 Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands (T.S.J.O., J.H.C.). Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands (T.S.J.O., J.H.C.). Search for more papers by this author , Dipender GillDipender Gill https://orcid.org/0000-0001-7312-7078 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (D.G.). Search for more papers by this author , G. Kees HovinghG. Kees Hovingh https://orcid.org/0000-0002-8145-1676 Department of Vascular Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands (J.M.K., G.K.H., E.S.G.S., N.S.N.). Search for more papers by this author , Alberico L. CatapanoAlberico L. Catapano https://orcid.org/0000-0002-7593-2094 Department of Pharmacological and Biomolecular Sciences, University of Milan, Milano, Italy (A.L.C.). IRCCS Multimedica, Milano, Italy (A.L.C.). Search for more papers by this author , Wolfgang KoenigWolfgang Koenig https://orcid.org/0000-0002-2064-9603 Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (W.K.). German Centre for Cardiovascular Research (DZHK e.V.), partner site Munich Heart Alliance, Germany (W.K). Institute of Epidemiology and Medical Biometry, University of Ulm, Germany (W.K.). Search for more papers by this author , Paul M RidkerPaul M Ridker https://orcid.org/0000-0003-1249-4522 Divisions of Preventive Medicine and Cardiovascular Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (P.M.R.). Search for more papers by this author , Erik S.G. StroesErik S.G. Stroes https://orcid.org/0000-0001-9555-6260 Department of Vascular Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands (J.M.K., G.K.H., E.S.G.S., N.S.N.). Search for more papers by this author and Nick S. NurmohamedNick S. Nurmohamed Correspondence to: Nick S. Nurmohamed, MD, Departments of Vascular Medicine and Cardiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Email E-mail Address: [email protected] https://orcid.org/0000-0001-9045-6009 Department of Vascular Medicine, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands (J.M.K., G.K.H., E.S.G.S., N.S.N.). Department of Cardiology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, The Netherlands (N.S.N.). Search for more papers by this author Originally published15 Jun 2023https://doi.org/10.1161/ATVBAHA.123.319272Arteriosclerosis, Thrombosis, and Vascular Biology. 2023;0FootnotesFor Sources of Funding and Disclosures, see page XXX.Correspondence to: Nick S. Nurmohamed, MD, Departments of Vascular Medicine and Cardiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Email n.s.[email protected]nl Previous Back to top Next FiguresReferencesRelatedDetails Advertisement Article InformationMetrics © 2023 The Authors. Arteriosclerosis, Thrombosis, and Vascular Biology is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.https://doi.org/10.1161/ATVBAHA.123.319272PMID: 37317854 Originally publishedJune 15, 2023 Keywordsinflammationproteomicslipid-lowering therapyphenotypecardiovascular diseasePDF download Advertisement SubjectsAtherosclerosisDiagnostic TestingLipids and CholesterolSecondary Prevention

An angiosome-centred approach for TcpO2 electrode positioning.

Background: The latest guidelines propose a TcpO2 value of 30 mmHg to help to confirm the diagnosis of chronic limb threatening ischemia. However, placement of electrodes is not standardised. The relevance of an "angiosome-centred" approach for TcpO2 electrode positioning has never been evaluated. We therefore retrospectively analysed our TcpO2 results to study the impact of electrode placement on the different angiosomes of the foot. Patients and methods: Patients consulting the vascular medicine department laboratory for suspicion of CLTI using TcpO2 electrodes placement on the different angiosome arteries of the foot (first inter metatarsal space, lateral edge of the foot and plantar side of the foot) were included. As the mean intra-individual variation is reported to be 8 mmHg, a variation of mean TcpO2 for the 3 locations ≤8 mmHg was considered to be not clinically significant. Results: Thirty-four patients (34 ischemic legs) were analysed. The mean TcpO2 was higher at the lateral edge of the foot (55 mmHg) and plantar side of the foot (65 mmHg) than at the first intermetatarsal space (48 mmHg). There was no clinically significant variation of mean TcpO2 according to anterior/posterior tibial artery patency and fibular artery patency. This was present when stratifying on the number of patent arteries. Conclusions: The present study suggests that multi-electrode TcpO2 is not useful to assess tissue oxygenation in the different angiosomes of the foot to guide surgical decision; first intermetatarsal electrode alone would be preferred. TcpO2 seems rather to evaluate overall tissue oxygenation of the foot. Electrode location on the plantar side of the foot may overestimate results and lead to misinterpretation.

Evaluation of the ankle brachial index and toe brachial index for peripheral arterial disease diagnosis in patients over 70years with lower limb ulcers.

The aim of our study was to evaluate the diagnostic performance of the ankle brachial index using pulsed Doppler, and the toe brachial index using laser Doppler, in comparison with the arterial Doppler ultrasound of the lower limbs as a reference test, in a population of non-diabetic subjects over 70years old with lower limb ulcers and without chronic renal failure. We included 50 patients, 100 lower limbs from the vascular medicine department of the Paris Saint-Joseph hospital from December 2019 to May 2021. We found a sensitivity of 54.5% for the ankle brachial index and a specificity of 67.6%. Regarding the toe brachial index, the sensitivity was 80.3% and the specificity 44.1%. We could explain the low sensitivity of the ankle brachial index in our population by the mediacalcosis of elderly subjects, avoidable with the measurement of the toe blood pressure index, which had a better sensitivity. In a population of subjects over 70years of age with a lower limb ulcer, without diabetes and without chronic renal failure, it would seem judicious to use the ankle brachial index in association with the toe brachial index for the diagnosis of peripheral arterial disease, followed by an arterial Doppler ultrasound of the lower limbs in order to evaluate the lesion profile of patients with a result of less than 0.7 of toe brachial index.

Editorial introductions.

Current Opinion in Lipidology was launched in 1990. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of lipidology is divided into six sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editor for this issue. SECTION EDITOR Erik StroesErik StroesErik S. G. Stroes is Chair of the Department of Vascular Medicine at the Academic Medical Center, Amsterdam, The Netherlands. After gaining his Doctor of Medicine degree from Erasmus University, Rotterdam, The Netherlands, he then specialized in internal medicine at University Medical Center, Utrecht, The Netherlands, and later in vascular medicine at the Academic Medical Center, Amsterdam. Professor Stroes’ research interests include the role of the vessel wall in atherosclerosis development and lipid disorders in relation to atherogenesis. He has been an investigator in numerous lipid-lowering trials using various surrogate markers, such as intima-media thickness and flow-mediated dilation, and more recently 3T magnetic resonance imaging as a surrogate marker for vascular disease progression. He has also been involved in the development of novel therapeutic moieties for dyslipidemia, such as lipoprotein lipase gene therapy, antisense oligonucleotide inhibition of apolipoprotein B synthesis, and reconstituted high-density lipoprotein infusion. He has been the recipient of numerous research grants and several awards. Professor Stroes is Chair of the Dutch Atherosclerosis Society, member of the Vascular Biology Working Group, member of the American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology, and former Chair of the Dutch Internist Vascular Society. He has published more than 300 papers in various peer-reviewed journals and authored several book chapters in the field. Gerald F WattsGerald F WattsGerald F Watts (DSc DM PhD FRCP FRACP) trained at Imperial College (St Mary's Hospital) and King's College (St Thomas’ Hospital) in the University of London. He is a consultant physician, specializing in lipid disorders and cardiovascular medicine, within the department of cardiology at Royal Perth Hospital, as well as Winthrop Professor of Cardiometabolic Medicine in the University of Western Australia. He is Chair of The Familial Hypercholesterolaemia (FH)-Australasia Network and executive board member of the International Atherosclerosis Society. His research interests include lipid disorders and cardiovascular prevention, with clinical interest focusing on delivering improved health care for patients and families with FH. Professor Watts is actively involved in undergraduate medical education and supervisors PhD students and post-doctoral fellows. He has authored over 500 published works, including scientific articles, reviews, book chapters and monographs, and is associate editor of Atherosclerosis, Journal Clinical Lipidology and Metabolism.

A Comparative Study of Xi's Tendon Gangrene (Nonischemic Type of Diabetic Foot) and Gangrene (Diabetic Foot Ischemic Type).

Background Diabetic foot gangrene refers to a lesion in which the tissue of the foot or lower extremities of diabetic patients is damaged, and the cause is the infection of peripheral blood vessels and neuropathy caused by diabetes. Objective To compare the related indexes of blood glucose, inflammation, blood viscosity, and peripheral neuropathy between the nonischemic diabetic foot and ischemic diabetic foot, the same and different characteristics of the two different types of diabetic foot in pathogenesis were discussed and studied. Methods A total of 122 patients with diabetic foot were selected from the Department of Vascular Medicine, Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, including 61 cases of ischemic type and 61 cases of nonischemic type. The differences in blood glucose, inflammation, blood supply, and peripheral neuropathy between the nonischemic diabetic foot and ischemic diabetic foot were compared to explore their different characteristics. Results The blood glucose index, inflammatory index, and plasma fibrinogen in patients with nonischemic diabetic foot were significantly higher than those in patients with ischemic diabetic foot (P < 0.05). The patients with ischemic diabetic foot were higher in age and blood lipid index than those with the nonischemic diabetic foot (P < 0.05), while having no significant difference in platelet count, plasma viscosity, hematocrit, and end products of glycation (AGEs). Conclusion The nonischemic diabetic foot is mainly infective necrosis, and the ischemic type is ischemic necrosis. The former occurs in the middle-aged and elderly with good blood supply between 40 and 60 years old, while the latter occurs in the elderly with the severe vascular disease over 60 years old. The blood glucose level of nonischemic patients is significantly higher than that of ischemic patients, but it has little to do with the course of diabetes.

Correlation between Age and Defect Size with Increased Pulmonary Arterial Pressure in Adult Atrial Septal Defect (ASD) Patients at Cardiology and Vascular Medicine Department dr. Seotomo Public Hospital Surabaya 2019-2021

Abstract: Atrial Septal Defect (ASD) is one of the three most common types of congenital heart disease in the world. Pulmonary arterial hypertension (PAH) is a complication that can be found in patients with secundum type of ASD. There is no research that shows the relationship between patient’s age and defect size with increased pulmonary artery pressure in secundum type of ASD patients in Indonesia, so further research needs to be done. Material and Methods: This study is a retrospective study using an observational analytical research design with cross sectionalapproach. The data from this study were taken from the medical records of ASD patients at the Cardiology and Vascular Department of Dr. Soetomo Public Hospital Surabaya. Results: Sex distribution of patients with secundum ASD was dominated by female patients with a total of 53 people (81.5%), the age distribution of patients was dominated by patients in the age group of 20-24 years as many as 18 people (27.7%). The most common comorbidities in adult secundum ASD patients were hypertension (3.08%) and minor CAD (3.08%). The mean diameter of the secundum ASD defect was 28.03±9.57 mm, and the data for the smallest defect diameter was 4 mm and the largest was 48 mm. Complications of increased PA pressure were dominated by 20 patients with mild PH (30.8%) and the mean mPAP pressure was 39.87±19.03. There were no patients with Eisenmenger syndrome.Conclusion: There was no correlation between patient age and inter-atrial septal diameter with mPAP pressure.

Incident cardiovascular events and early mortality in patients with revascularized critical limb ischemia.

Patients with critical limb ischemia (CLI) present a high risk of cardiovascular events and death. This study aimed to investigate the incidence of major adverse cardiovascular events (MACE) and one-year mortality in patients undergoing percutaneous revascularization procedure for CLI. This investigation is a retrospective analysis of an ongoing cohort study in patients with CLI undergoing endovascular revascularization, hospitalized in the vascular medicine department from November 2013 to December 2018. Major cardiovascular events were collected during the first year after revascularization procedure and were defined as heart failure, acute coronary syndrome, ischemic stroke and sudden death. Mortality and major limb amputations, defined as above-the-ankle amputation, were determined during the one-year follow-up period. Multivariate logistic regression analyses were performed to identify factors independently associated with the occurrence of MACE and one-year mortality after revascularization procedure. A P≤0.05 was considered as statistically significant. The study included 285 consecutive patients, 157 men (55%) and 128 women (45%), with a mean age of 77.8±12 years. Treated hypertension was present in 222 (78%) patients; diabetes was present in 137 (48%) patients; 112 (39%) patients had known coronary heart disease and 20 (7%) patients were dialysis dependent. During the one-year follow-up after revascularization procedure, 75 (26.3%) patients presented an incident cardiovascular event, of whom 19 (6.7%) patients in the perioperative period. Cumulative mortality rate was 26.7% (76 patients) mostly from cardiovascular causes. Twenty-five patients (8.8%) experienced major amputation. In multivariate analysis, the occurrence of MACE was associated with an increased mortality risk (HR 6.96 (2.99-16.94), P<0.001). Other variables associated with an increased mortality were living in a nursing home and malnutrition. Decompensated heart failure and coronary heart disease were both associated with incident MACE in multivariate analysis, independently of confounders. In the present study population, incident MACE were prevalent in the year following endovascular revascularization procedure in patients with CLI and were associated with an increased risk of mortality. Coronary heart disease and decompensated heart failure are important contributors for the occurrence of MACE. In this elderly patient population with CLI, these results should be taken into account during the multidisciplinary team meeting before consideration of revascularization procedure.

MANAGEMENT OF SEVERE XEROSTOMIA AND ORAL CANDIDIASIS IN PATIENT WITH VALVULAR HEART DISEASE: A CASE REPORT

Background : Valvular heart disease is a heart valve disorder that needs complex multiple medications by administering certain drugs that cannot be replaced with other drugs because of different mechanisms of action. Beta-blockers and Angiotensin-Converting Enzyme inhibitors are drugs of choice for valvular heart disease, with diuretics and antipsychotics can cause xerostomia. Valvular heart disease patient who has a severe infection or sepsis needs long-term antibiotic treatment. Xerostomia and long-term antibiotic treatment are predisposing factors for oral candidiasis. Objective : to discuss oral candidiasis and severe xerostomia because of multiple medications in valvular heart disease patients. Case : A 58-year-old male was referred from Cardiology and Vascular Medicine Department with a chief complaint of sore tongue and pain at swallowing since 3 days ago with dry sensation of the mouth. Extraoral examination revealed dry and exfoliative lips, intraoral examination revealed fissured and lobulated tongue and white plaques could be scraped off leaving erythematous area oropharynx and tongue. The diagnoses were oropharyngeal candidiasis and severe xerostomia score of 8 according to the Chalacombe scale. Case Management : Patient was treated with nystatin, chlorine dioxide, 0.12 % chlorhexidine digluconate mouthwash, and vaseline album. Oral candidiasis was disappeared on the 22nd day of treatment. Conclusion : Xerostomia and oral candidiasis in patients with valvular heart disease require appropriate therapy, more intensive monitoring by considering the patient's general condition, and interprofessional team collaboration in the therapy of the main disease. Keywords: Oral candidiasis, Valvular heart disease, Xerostomia

MANAGEMENT OF SEVERE XEROSTOMIA AND ORAL CANDIDIASIS IN PATIENT WITH VALVULAR HEART DISEASE: A CASE REPORT

Background: Valvular heart disease is a heart valve disorder that needs complex multiple medications by administering certain drugs that cannot be replaced with other drugs because of different mechanisms of action. Beta-blockers and Angiotensin-Converting Enzyme inhibitors are drugs of choice for valvular heart disease, with diuretics and antipsychotics can cause xerostomia. Valvular heart disease patient who has a severe infection or sepsis needs long-term antibiotic treatment. Xerostomia and long-term antibiotic treatment are predisposing factors for oral candidiasis. Objective: to discuss oral candidiasis and severe xerostomia because of multiple medications in valvular heart disease patients. Case: A 58-year-old male was referred from Cardiology and Vascular Medicine Department with a chief complaint of sore tongue and pain at swallowing since 3 days ago with dry sensation of the mouth. Extraoral examination revealed dry and exfoliative lips, intraoral examination revealed fissured and lobulated tongue and white plaques could be scraped off leaving erythematous area oropharynx and tongue. The diagnoses were oropharyngeal candidiasis and severe xerostomia score of 8 according to the Chalacombe scale. Case Management: Patient was treated with nystatin, chlorine dioxide, 0.12 % chlorhexidine digluconate mouthwash, and vaseline album. Oral candidiasis was disappeared on the 22nd day of treatment. Conclusion: Xerostomia and oral candidiasis in patients with valvular heart disease require appropriate therapy, more intensive monitoring by considering the patient's general condition, and interprofessional team collaboration in the therapy of the main disease. Keywords: Oral candidiasis, Valvular heart disease, Xerostomia

Clinical profile of patients with peripheral artery disease treated with high-pressure intermittent pneumatic compression in st. lukes medical center-quezon city: a 6-year retrospective cohort study

Abstract Background High-pressure intermittent pneumatic compression (HPIPC) has been proposed as an alternative intervention to supervised exercise to improve intermittent claudication in patients with peripheral artery disease (PAD). This intervention has already been introduced in the Philippines. However, no local data have been published regarding the clinical profile of patients with PAD treated with HPIPC. This study aims to determine the clinical profile of patients with PAD treated with HPIPC in our Medical Center from March 2015 to March 2021. Purpose Knowledge about the clinical profile of patients with PAD treated with HPIPC in SLMC-QC will provide local data that can lead to better planning of the next generation of PAD care in our institution or even in the Philippines. This study can therefore serve as a baseline for further studies to identify clinical outcomes using HPIPC. Methods A total of eighty-three (N=83) adult patients aged ≥19 years with confirmed diagnosis of PAD and symptoms of intermittent claudication who received at least 12 sessions of HPIPC in the Department of Vascular Medicine from March 2015 to March 2021 were included in this retrospective cohort study. The primary outcome was identification of the clinical profile of the study population that included age, sex, smoking history and co-morbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, coronary artery disease (CAD) and chronic kidney disease (CKD). The secondary outcome was description of the clinical outcomes of the study population after a minimum of 12 sessions of HPIPC. Descriptive statistics were generated for all variables. Continuous variables were presented as mean (standard deviation, SD)'. Nominal and ordinal data were reported as frequencies and percentages. All data were analyzed using Statistical Package for the Social Sciences (SPSS) v27 software. The flow diagram of the study is shown in Figure 1. Results The mean (SD)' age of the study population was 75 (14)' years. Approximately 76% of them were aged ≥65 years. Overall, there were more males (57%) than females (43%) in the study. Majority of the study population were never-smokers (70%), had hypertension (89%), DM (81%), dyslipidemia (78%) and abnormal ankle-brachial index (ABI, 80%). The mean (SD)' ABI of the study population was 0.92 (0.5)'. 92% had hemodynamically significant stenosis in the distal arterial segments of the lower extremities while 62% had hemodynamically significant stenosis in the proximal arterial segments of the lower extremities (Table 1). Conclusion Age ≥65 years, male sex, never-smoker, hypertension, DM and dyslipidemia defined the clinical profile of patients with PAD treated with HPIPC in SLMC-QC from March 2015 to March 2021. Appropriate management of these risk factors can lead to better PAD care in the institution. Further studies are recommended to determine the efficacy of HPIPC in the treatment of PAD. Funding Acknowledgement Type of funding sources: None. Figure 1. Flow diagram of the studyTable 1. Results of the study

William R. Hiatt

Free AccessWilliam R. HiattJune 1, 1950–December 8, 2020Published Online:February 28, 2021https://doi.org/10.1024/0301-1526/a000936PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreWe are deeply saddened to announce that Dr. William R. Hiatt passed away on December 8, 2020. Dr. Hiatt dedicated his life to improving the care of patients. His death represents a profound loss of one of the pillars of Vascular Medicine and cardiovascular research as well as a dedicated mentor to many of us. He dedicated his knowledge to all of us, irrespective if cardiologist, angiologist, cardiac or vascular surgeon, or pure researcher.William R. Hiatt was born 1950 in Colorado. He graduated from the University of Colorado School of Medicine and after his Internal Medicine residency in Boston and he completed his fellowship in Vascular Medicine at the University of Colorado. He became Professor of Medicine at University of Colorado where he held the Novartis Foundation Endowed Chair in Cardiovascular Research.Dr Hiatt dedicated his career to the care of patients with vascular disease, particularly peripheral artery disease. He was a Past President of the Society of Vascular Medicine. In addition, he served as Chair of the American Heart Association’s Council on Peripheral Vascular Disease. He was also a co-editor for the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines. During his career he received numerous awards for his work, including the designation as a Master of the Society for Vascular Medicine and the Distinguished Scientist and Clinical Research Scientist Awards from the American Heart Association.He realized that he could have the greatest impact on patient outcomes by not only caring for individuals in clinic but also through leading cardiovascular research. He served as a member on several FDA Advisory Committees and the Chair of the US FDA Cardiovascular and Renal Division Advisory Committee. He was recognized with the FDA Advisory Committee Service Award in 2008.He published over 280 manuscripts, including landmark publications evaluating optimal therapies in peripheral artery disease and authored over 60 book chapters. He served as a teacher and mentor for numerous physician scientists and provided care to countless patients with complex cardiovascular disease. Will Hiatt dedicated extensive effort to physiologic studies and became a master of measuring functional outcomes. His mission to improve outcomes in peripheral artery disease spanned early and late phase trials, small and big studies, population studies, and registration pathway trials. His work led to the collaborative leadership of the EUCLID trial [1], the largest dedicated PAD medical therapy trial. One of his greatest and his latest achievement was the leadership and execution of VOYAGER PAD [2]. This trial had a major impact on reducing major cardiac and limb events in patients suffering from peripheral artery disease requiring lower extremity revascularization, and he gratefully was just able to finish this landmark trial. His legacy of dedication to the care of patients with peripheral artery disease has helped to transform research in this area and holds promise to improve outcomes in this high-risk population.Will was not just a remarkable physician and scientist. He was a remarkable human being. He was uncommonly grounded, humble, grateful and generous. Will didn′t care for profession, origin and community. Everyone, independent of her/his profession, was heartedly welcomed by him, and he truly was a great mentor to all of us, having had the honor of working with him and share his thoughts. For many of us, he was a true friend. Will had a sense of higher mission – beyond our daily tasks. His high sense for ethical attitude was summarized in the Code of the West [3]:Live each day with courageTake pride in your workAlways finish what you startDo what has to be doneBe tough, but fairWhen you make a promise, keep itRide for the brandTalk less and say moreRemember that some things aren’t for saleKnow where to draw the lineSebastian Debus, Rupert Bauersachs and Marc BonacaReferences1 Hiatt WR, Fowkes FG, Heizer G, et al. Ticagrelor versus clopidogrel in symptomatic peripheral artery disease. N Engl J Med. 2017;376:32–40. Crossref Medline, Google Scholar2 Bonaca MP, Bauersachs RM, Anand SS, et al. Rivaroxaban in peripheral artery disease after revascularization. N Engl J Med. 2020;382:1994–2004. Crossref Medline, Google Scholar3 Owen JP. Cowboy ethics. Ketchum, USA: Stoecklein Publishing; 2005. Google ScholarProf. Dr. Rupert Bauersachs, Director of the Department of Vascular Medicine – Angiology, Vascular Center, Klinikum Darmstadt GmbH, Grafenstraße 9, 64283 Darmstadt, Germany, E-mail bauersachs@em.uni-frankfurt.deFiguresReferencesRelatedDetails Volume 50Issue 2February 2021ISSN: 0301-1526eISSN: 1664-2872 InformationVasa (2021), 50, pp. 157-157 https://doi.org/10.1024/0301-1526/a000936.© 2021Hogrefe AGPDF download

Editorial introductions

Current Opinion in Lipidology was launched in 1990. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of lipidology is divided into six sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Erik S.G. StroesErik S.G. StroesErik S.G. Stroes is Chair of the Department of Vascular Medicine at the Academic Medical Center, Amsterdam, The Netherlands. After gaining his Doctor of Medicine degree from Erasmus University, Rotterdam, The Netherlands, he then specialized in internal medicine at University Medical Center, Utrecht, The Netherlands, and later in vascular medicine at the Academic Medical Center, Amsterdam. Professor Stroes’ research interests include the role of the vessel wall in atherosclerosis development and lipid disorders in relation to atherogenesis. He has been an investigator in numerous lipid-lowering trials using various surrogate markers, such as intima-media thickness and flow-mediated dilation, and more recently 3T magnetic resonance imaging as a surrogate marker for vascular disease progression. He has also been involved in the development of novel therapeutic moieties for dyslipidemia, such as lipoprotein lipase gene therapy, antisense oligonucleotide inhibition of apolipoprotein B synthesis, and reconstituted high-density lipoprotein infusion. He has been the recipient of numerous research grants and several awards. Professor Stroes is Chair of the Dutch Atherosclerosis Society, member of the Vascular Biology Working Group, member of the American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology, and former Chair of the Dutch Internist Vascular Society. He has published more than 300 papers in various peer-reviewed journals and authored several book chapters in the field. Gerald F. WattsGerald F. WattsGerald F. Watts (DSc DM PhD FRCP FRACP) trained at Imperial College (St Mary's Hospital) and King's College (St Thomas’ Hospital) in the University of London. He is a consultant physician, specializing in lipid disorders and cardiovascular medicine, within the department of cardiology at Royal Perth Hospital, as well as Winthrop Professor of Cardiometabolic Medicine in the University of Western Australia. He is Chair of The Familial Hypercholesterolaemia (FH)-Australasia Network and executive board member of the International Atherosclerosis Society. His research interests include lipid disorders and cardiovascular prevention, with clinical interest focusing on delivering improved health care for patients and families with FH. Professor Watts is actively involved in undergraduate medical education and supervisors PhD students and post-doctoral fellows. He has authored over 500 published works, including scientific articles, reviews, book chapters and monographs, and is associate editor of Atherosclerosis, Journal Clinical Lipidology and Metabolism.

Editorial introductions

Current Opinion in Lipidology was launched in 1990. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of lipidology is divided into six sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Erik S.G. StroesErik S.G. Stroes is Chair of the Department of Vascular Medicine at the Academic Medical Center, Amsterdam, The Netherlands. After gaining his Doctor of Medicine degree from Erasmus University, Rotterdam, The Netherlands, he then specialized in internal medicine at University Medical Center, Utrecht, The Netherlands, and later in vascular medicine at the Academic Medical Center, Amsterdam. Professor Stroes’ research interests include the role of the vessel wall in atherosclerosis development and lipid disorders in relation to atherogenesis. He has been an investigator in numerous lipid-lowering trials using various surrogate markers, such as intima-media thickness and flow-mediated dilation, and more recently 3T magnetic resonance imaging as a surrogate marker for vascular disease progression. He has also been involved in the development of novel therapeutic moieties for dyslipidemia, such as lipoprotein lipase gene therapy, antisense oligonucleotide inhibition of apolipoprotein B synthesis, and reconstituted high-density lipoprotein infusion. He has been the recipient of numerous research grants and several awards. Professor Stroes is Chair of the Dutch Atherosclerosis Society, member of the Vascular Biology Working Group, member of the American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology, and former Chair of the Dutch Internist Vascular Society. He has published more than 300 papers in various peer-reviewed journals and authored several book chapters in the field. Gerald F. WattsGerald F. Watts (DSc, DM, PhD, FRCP, FRACP) trained at Imperial College (St Mary's Hospital) and King's College (St Thomas’ Hospital) in the University of London. He is a consultant physician, specializing in lipid disorders and cardiovascular medicine, within the department of cardiology at Royal Perth Hospital, as well as Winthrop Professor of Cardiometabolic Medicine in the University of Western Australia. He is Chair of The Familial Hypercholesterolaemia (FH)-Australasia Network and executive board member of the International Atherosclerosis Society. His research interests include lipid disorders and cardiovascular prevention, with clinical interest focusing on delivering improved health care for patients and families with FH. Professor Watts is actively involved in undergraduate medical education and supervisors PhD students and post-doctoral fellows. He has authored over 500 published works, including scientific articles, reviews, book chapters and monographs, and is associate editor of Atherosclerosis, Journal Clinical Lipidology and Metabolism.

Impact of an Educational Intervention on Ankle–Brachial Index Performance Among Medical Students and Fidelity Assessment at Six Months

The resting ankle-brachial index (ABI) is a clinical test to diagnose peripheral artery disease. The Wyatt's score has been proposed to assess the students' performance on ABI measurement on a healthy volunteer (HV). No study has shown that this score is sensitive to different teaching methods. In this randomized controlled trial, we wanted to determine whether didactic learning alone or didactic learning combined with experiential learning improves proficiency in the ABI procedure assessed by the Wyatt's score. Medical students (n=30) received a didactic learning, including (1) a presentation of the ABI guidelines and (2) a video demonstration. Each student was then randomized into 2 groups ("the no experiential learning group" and "the experiential learning group"). An initial evaluation was performed after the didactic learning and then the final evaluation at the end of the intervention. A student was considered to be proficient when he performed a correct ABI procedure on an HV. The correct procedure corresponds to the following: (1) correctly answered Wyatt's score and (2) a difference in the ABI measurement between a professor in vascular medicine and a student was ≤0.15. No student was proficient at the initial evaluation. At the final evaluation, there was a significant difference between the number of proficient students for the Wyatt's score depending on their learning group [didactic alone (1/10) or didactic+experiential training (15/20)] and also for the ABI procedure [didactic alone (0/10) or didactic+experiential training (16/20)]. At 6 months, among the 12 students who passed the final evaluation, 4 students passed both the Wyatt's score and the ABI measurement. Our study demonstrates that the Wyatt's score was sensitive to an educational intervention and no improvement was found in the case of "no experiential learning." The Wyatt's score could be used to evaluate the student on ABI measurement after an educational intervention. A randomized controlled trial was conducted in the Vascular Medicine Department of Rennes University Hospital (France). This was approved by the ethics review board of our institution (no. 16.150).

Prevalence and severity of peripheral arterial disease among patient with heel pressure ulcer: a retrospective study of 42 patients.

Heel pressure ulcer is a major complication in elderly hospitalized patients. The association with peripheral arterial disease (PAD) which is also a frequent disease in this population is poorly known. The aim of this study was to assess the prevalence of PAD and critical limb ischemia (CLI) in patients with heel pressure ulcer. Patients referred to the vascular medicine department for heel pressure ulcer from October 2014 to June 2015 were included in the study. The assessment of peripheral arterial disease was made with the results of ankle brachial index and/or doppler ultra sound of lower limb arteries. Toe systolic pressure and transcutaneous pressure (TcPO2) were also recorded, and the diagnosis of critical limb ischemia was made according to the TASC 2 criteria. The population was composed with 42 patients (women 43%, men 57%). The mean age was 81±11 years. Heel pressures ulcers were diagnosed in the following situations: lower limb fracture (31%), acute medical illness (21%), multiple chronic conditions (28%) and critical care unit hospitalization (7%). A peripheral arterial disease was present in 31 patients (73%), and a critical limb ischemia in 7 patients. For 18 patients, PAD was not known in their past medical history, and this was the case of 5 patients among those with critical limb ischemia. A revascularization was performed in 12 patients, and 5 patients undergo a lower limb amputation. 12 patients were died at 3 months. PAD is frequent among patients with heel pressure ulcer, and is often unknown. The functional and vital prognostic are poor, and the results of our study emphasize the importance of screening PAD in the evaluation of heel pressure ulcer risk.

Descriptive study of relationship between cardio-ankle vascular index and biomarkers in vascular-related diseases

ABSTRACTBackground: Cardio-ankle vascular index (CAVI) was supposed to be an independent predictor for vascular-related events. Biomarkers such as homocysteine (Hcy), N-terminal pro-brain natriuretic peptide (NT-proBNP), and urine albumin(microalbumin) (UAE) have involved the pathophysiological development of arteriosclerosis. The present study was to investigate relationship between CAVI and biomarkers in vascular-related diseases. Methods: A total of 656 subjects (M/F 272/384) from department of Vascular Medicine were enrolled into our study. They were divided into four groups according to the numbers of suffered diseases, healthy group (group 0: subjects without diseases of hypertension, diabetes mellitus (DM), coronary heart disease (CHD); n = 186), group 1 (with one of diseases of hypertension, CHD, DM; n = 237), group 2 (with two of diseases of hypertension, CHD, DM; n = 174), and group 3 (with all diseases of hypertension, CHD, DM; n = 59). CAVI was measured by VS-1000 apparatus. Results: CAVI was increasing with increasing numbers of suffered vascular-related diseases. Similar results were found in the parameters of biomarkers such as Hcy, log NT-ProBNP, and log UAE. There were positive correlation between log NT-proBNP, Hcy, log UAE, and CAVI in the entire study group and nonhealthy group. Positive correlation between log UAE and CAVI were found in the entire study group after adjusting for age, body mass index (BMI), blood pressure, uric acid, and lipids. Multivariate analysis showed that log UAE was an independent associating factor of CAVI in all subjects. Conclusions: CAVI was significantly higher in subjects with hypertension, CHD, and DM. There was correlation between arterial stiffness and biomarkers such as NT-proBNP, Hcy, and UAE.

Atteinte macrovasculaire de la sclérodermie systémique : étude descriptive prospective de 20 patients en échodoppler

Systemic sclerosis is characterized by cutaneous sclerosis, vascular disease and immunological dysfunction. The prevalence of macrovascular disease remains controversial. This was a descriptive prospective single-center study conducted in the vascular medicine department of the University Hospital of Bordeaux from July 1 to September 1, 2015. All inpatients followed for systemic scleroderma were included. Each patient had a Doppler ultrasound of the supra-aortic, upper and lower limb, and digital arteries as well as the aorta. The main objective of the study was to describe the presence and location of arterial lesions in patients with systemic sclerosis. Of the twenty patients included, there were 13women and 7men; mean age was 58±16years. Patients exhibited wall thickening (n=16, 80%), calcified plaques (n=10, 50%), hemodynamically significant stenoses (n=3, 15%) and arterial occlusions (n=12, 60%). Ankle brachial pressure index (ABPI) was 0.98±0.16on the right and 0.99±0.21on the left. Two patients had ABPI<0.8. The mean brachial systolic blood pressure was 113±14mmHg. Arterial mapping (860arterial sites) found wall thickening (n=93arteries, 10%), calcified plaques (n=47, 5%), hemodynamically significant stenoses (n=7) and occlusions (n=22). Arterial occlusions were located in the ulnar arteries (n=2), the digital arteries (n=18), the posterior tibial artery (n=1) and the dorsalis pedis artery (n=1). The data of our study correlate with macrovascular disease described in the literature. This finding raises two questions: how does this concept integrate with the severity of Raynaud's phenomenon and the risk of digital ulcers and changes in patients' capillaroscopic landscape during follow-up? What is the cause of these vascular anomalies, some of which are very different from what is observed in atherosclerosis?

Low miR-19b-1-5p expression in isolated platelets after aspirin use is related to aspirin insensitivity

a Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands b Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands c Department of Hypertension and Dyslipidemia, Geriatric Clinic and European Center on Atherosclerosis, G. D'Annunzio University, Chieti, Italy d Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands e Department of Experimental Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands f Department of Clinical Chemistry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands g Department of Plasma Proteins, Sanquin, Amsterdam, The Netherlands

Theme 3: Non-invasive management of (recurrent) venous thromboembolism (VTE) and post thrombotic syndrome (PTS)

a Maastricht University Medical Center, Laboratory for Clinical Thrombosis and Hemostasis, Cardiovascular Research Institute Maastricht (CARIM), Netherlands b Thrombosis Center, USA c McMaster University and Thrombosis and Atherosclerosis Research Institute, Canada d Vanderbilt University, Department of Pathology, Microbiology and Immunology, Nashville, USA e University of Groningen, University Medical Center Groningen, Department of Hematology, Netherlands f University of Leeds, Division of Cardiovascular and Diabetes Research, The LIGHT Labs, Leeds, UK g University of Amsterdam, Academic Medical Center, Department of Vascular Medicine, Netherlands h Erasmus University Medical Center, Rotterdam, Department of Hematology, Netherlands

Editorial introductions

Current Opinion in Lipidology was launched in 1990. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of lipidology is divided into six sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Kausik K. RayKausik K. RayProfessor Ray received his medical education (MB ChB, 1991) at the University of Birmingham Medical School, UK. His clinical training in Cardiology was conducted in Birmingham and Sheffield and he obtained his MD (2004) at the University of Sheffield, UK, for work on the interleukin 1 system and its influence on endothelial function, inflammation and coronary disease. He pursued a postdoctoral fellowship at Harvard Medical School, USA, under Professor Braunwald and Professor Cannon and finally an MPhil in epidemiology (2007) from the University of Cambridge, UK. A Fellow of the American College of Cardiology, the European Society of Cardiology, the American Heart Association and the Royal College of Physicians, Kausik Ray is also a member of the British Cardiovascular Society and the European Atherosclerosis Society (EAS) Consensus Panel. Professor Ray has been the national lead investigator, served on the committees or been PI for several major medical trials, including T-EMERGE 8, SOLID TIMI 52, SAVOR TIMI 54, DAL OUTCOMES II, DAL-ACUTE, ODYSSEY OUTCOMES, DECLARE TIMI 58, CAMELIA TIMI 61 and THEMIS. Professor Ray's research interests have focused on large scale population studies and trials for the prevention and reduction of coronary events. He has investigated the early benefits of high intensity statin therapy, the advantages of more/less intensive glycaemic control, and the risks/benefits of aspirin therapy. These have influenced American Heart Association/American College of Cardiology and European Society of Cardiology guidelines. His work on statins and diabetes risk led to a global label change for statins by the FDA and EMEA. He continues to investigate the role of lipids, lipoproteins, diabetes, inflammation and thrombosis, and coronary events. Professor Ray has published his research in numerous journals including the New England Journal of Medicine, Lancet, The Journal of the American Medical Association, Archives of Internal Medicine, Circulation, the Journal of the American College of Cardiology, and the European Heart Journal. Currently, Professor Ray leads the EAS familial hypercholesterolaemia (FH) Studies Collaboration and the first global FH registry as well as being the principal investigator for the TOGETHER study assessing vascular risk in 250 000 individuals in London. G. Kees HovinghG. Kees HovinghDr G. Kees Hovingh (1974) is an internist, vascular medicine specialist and staff member at the Department of Vascular Medicine at the Academic Medical Center (AMC) of the University of Amsterdam, the Netherlands. He received his medical degree at Groningen University, the Netherlands, in 2000. During his study, he spent one year (1999) at the department for organ transplantation at Massachusetts General Hospital, Boston, USA. In 2001, he started his PhD under supervision of Prof. dr J.J.P. Kastelein, head of the Department of Vascular Medicine at the AMC. During his PhD, several studies were performed which ranged from clinical intervention trials to basic-research, including large scale sequencing of candidate genes. During his thesis, Dr Hovingh focused on studies to unravel the molecular defects underlying HDL disorders and studies addressing its consequences for atherosclerosis progression. Dr Hovingh has identified mutations in a large number of pivotal genes in lipid metabolism. In 2005, Dr Hovingh started his residency in internal medicine at the AMC. Between 2007 and 2008, he was trained in molecular medicine as a post-doctoral fellow in the Genetics Department at Harvard Medical School, Boston, USA. Under the supervision of Profs. C.E. Seidman and J. Seidman he worked on a novel subgenome capture method for next generation sequencing. Dr Hovingh's position at the AMC and the department of Vascular Medicine allows him to devote his time to science, and in particular to scientific guidance of PhD students. Moreover, his clinical position does enable him to identify patients with extreme lipid phenotypes. He is head of the clinical trial unit and is (co-author) on 130 peer reviewed manuscripts.