Incidence Of Arterial Disease Research Articles

Influenza vaccination reduces incidence of peripheral arterial occlusive disease in elderly patients with chronic kidney disease

An influenza vaccination might reduce the risk of incident peripheral arterial occlusive disease (PAOD) in patients with chronic kidney disease (CKD), but supporting evidence is limited. This case-crossover study analyzed data from Taiwan’s real-world National Health Insurance Research Database. This study included elderly (≥ 67 years old) patients with CKD having incident PAOD from January 1, 2006, to June 30, 2015. We defined 1 year before PAOD onset as the index date for the self-control group. A conditional logistic regression model was used to investigate exposure to an influenza vaccination for estimating the risk for incident PAOD following vaccination. In total, this study included 46,782 elderly patients with CKD having incident PAOD. The odds ratios for incident PAOD were 0.85 (95% confidence interval 0.77–0.94), 0.85 (0.79–0.92), 0.84 (0.79–0.90), and 0.85 (0.81–0.90) at 1, 2, 3, and 4 months after an influenza vaccination, respectively. We observed consistent results for the subgroups of patients with CKD and concomitant diabetes. However, we did not observe any beneficial effects of influenza vaccination in patients with advanced CKD or end-stage renal disease. This study demonstrated that influenza vaccination may be associated with a reduced risk of incident PAOD among patients with early-stage CKD.

Epicardial fat tissue: a new tool for identification of coronary artery disease patients?

Abstract Introduction Epicardial fat (EF), the true visceral fat depot of the heart, has been strongly correlated with both coronary artery disease (CAD) incidence and severity. However, the methods for its measurement were not always affordable. Its measurement by echocardiography is fast, accessible and easily reproducible, turning it into a promising clinical tool for assessing cardiovascular risk to predict the incidence of CAD. Purpose To determine the correlation between EF tissue dimensions measured by transthoracic echocardiography and the presence of CAD. Methods We prospectively analysed data from 196 consecutive patients admitted for acute coronary syndrome in our coronary care unit. All patients underwent diagnostic coronary angiography and echocardiogram during stay. EF dimensions were obtained with transthoracic echocardiography by measuring maximum EF diameter (mm) at the basal right ventricular free wall (PLAXB) level and mid-right ventricular free wall (PLAXM) level [in paraesternal long-axis view (PLAX)] and maximum right-ventricle free wall EF diameter at basal (PSAXB) level and papillary-muscle (PSAXM) level [in paraesternal short-axis view (PSAX)]. All measures were taken at end-systole. Patients were divided in 2 groups according to the presence of significant CAD (sCAD) or not (nCAD), defined as having at least 1 diseased epicardial vessel with a stenosis >50%. Results One-hundred and sixty-three (83.2%) had significant CAD. 22 patients (11.2%) were admitted for unstable angina, 60 patients (30.6%) for non-ST elevation myocardial infarction and 93 patients (47,4%) for ST-elevation myocardial infarction. Mean EF diameters were as follows: PLAXB (19,3±5.1 mm), PLAXM (11.3±2.6), PSAXB (10,6±2.8), PSAXM (10.5±2.8). We found a direct correlation between number of diseased epicardial coronary vessels and epicardial fat thickness in PLAXB (r=0.506, p<0.001), PLAXM (r=0.372, p<0.001), PSAXB (r=0.445, p<0.001) and PSAXM (r=0.372, p<0.001). EF was significantly different between groups: PLAXB (20,6±4.4 vs. 13.8±3,8, p<0.001), PLAXM (11.8±2.5 vs. 9.0±1.9, p<0.001), PSAXB (11.1±2.7 vs. 8.3±2.3, p<0.001) and PSAXM (11.0±2.6 vs. 8.2±4, p<0.001). Receiver operating characteristic curve analysis showed that the predictive value of mean right ventricular EF [(PLAXB+PSAXB)/2] for significant CAD was 0.895 (AUC=0.895, CI 95% 0.818–0,972, p<0.001). For a [(PLAXB+PLAXM)/2] value of 12.57 mm, sensitivity was 86.3% and specificity was 79.3%. Conclusions In a population of high suspicion of acute coronary syndromes, echocardiographic EF is a sensitive and specific marker of the presence of significant coronary disease and could become an important tool for coronary risk prediction. Figure 1 Funding Acknowledgement Type of funding source: None

Abstract 333: Cardiovascular Disease Risk Factor Disparities in the US Veteran and Civilian Population

Background: The mortality rate of US Veterans is greater than that of civilians, and US Veterans experience disproportionately higher burden of medical comorbidities. Disparities in coronary artery disease (CAD) incidence and its risk factors between US veterans and civilians has not previously been reported. This study seeks to identify disparities in the incidence of CAD and CAD risk factors in US veterans and the general population. Methods: A total of 1535 consecutive US Veterans presenting for left heart catheterization (LHC) were reviewed. We present risk factor burden, LHC outcome, and mortality with mean follow-up time of 112 ± 65.2 months. Results: At mean follow-up of 112 months (9.3 years), all-cause mortality was 68.3%. 12.7% had normal coronaries (NC), 14.9% had non-obstructive coronary artery disease and 72.3% had obstructive coronary artery disease (ObCAD). Mean BMI was 30.0; 87.8% had hypertension (HTN), 78.1% had hyperlipidemia (HLD), 52.2% has reduced ejection fraction (rEF), 45.5% had diabetes (DM), and 17.5% had chronic kidney disease (CKD). In order of decreasing Cox hazard, six risk factors (CKD, rEF, PVD, HTN, obesity and DM) were independent predictors of mortality. Conclusion: Mortality and incidence of ObCAD in US veterans are notably greater than in the American general population (per the CDC National Health Report) and other developed countries (per the WHO NCD Report). Compared to the general population, there is greater burden of HTN, HLD, DM and CKD in US Veterans. Among US Veterans, CKD carried a greater HR compared to HTN and DM, with no significant HR for HLD. This differs markedly from the general population studied in the REACH registry which established HTN, HLD and DM as the greatest predictors of cardiovascular mortality. The low hazard of HLD was likely secondary to its ubiquity in most patients in the cohort, regardless of CAD status. US Veterans have unique healthcare needs and our study guides which risk factors need to be managed to improve disparities in US Veteran health.

Anesthetic management of surgical interventions in patients with diabetic foot syndrome

Objective. To study the issues of anesthetic management of surgical interventions in patients with diabetic foot syndrome. In our work, the analysis of specialized literature and research on the anesthetic management of surgical interventions in patients with diabetic foot syndrome was performed. Most often diabetic foot syndrome (DFS) occurs in patients with severe diabetes and co-morbidities, and there are strict requirements for anesthesia safety for surgical interventions in DFS patients and minimal impact on carbohydrate metabolism and CNS functions. The results of the literature review have shown that preference is given to the regional methods of anesthesia as they allow patients to maintain a dietary pattern and insulin regimen, to reduce the risk of intraoperative complications in concomitant coronary artery disease, heart failure, cardiac arrhythmias, hypertension, renal failure, and pulmonary embolism incidence. Taking the above into account as well as cost-effectiveness and availability of modern navigation tools (for example, USD) for regional anesthesia performing, make it the most appropriate when choosing anesthesia technique in DFS patients. Conclusions. An improvement of the treatment effectiveness as a whole and patient’s long-term quality of life must be taken into consideration when choosing an anesthesia method. Based on foreign and domestic studies, it can be argued that regional anesthesia is very beneficial and best for anesthesiologists and surgeons and, above all, for patients with DFS.

THE INFLUENCE OF ANNOYANCE DUE TO AIRCRAFT NOISE ON RENAL HEMODYNAMIC

Objective:Epidemiological evidence suggests a link between noise exposure and increased incidence of arterial hypertension and cardiovascular disease. The kidney as long-term regulator of blood pressure might play a role in the underlying pathophysiological mechanism. The aim of this study is to inv

Peripheral Arterial Disease (PAD) Prevalence and Incidence with Cardiovascular Risk Factors in the Rural Population of Gueoul (Senegal)

Peripheral Arterial Disease (PAD) Prevalence and Incidence with Cardiovascular Risk Factors in the Rural Population of Gueoul (Senegal)

P6241Degree and incidence of coronary heart disease and peripheral arterial disease in a large cohort of patients with extremely elevated lipoprotein(a) levels

P6241Degree and incidence of coronary heart disease and peripheral arterial disease in a large cohort of patients with extremely elevated lipoprotein(a) levels

Abstract MP010: A Prospective Study of DNA Methylation Age Acceleration and Incidence of Coronary Heart Disease, Heart Failure, and Peripheral Arterial Disease in the Atherosclerosis Risk in Communities (ARIC) Study

Introduction: DNA methylation patterns used to characterize rate of aging (i.e., epigenetic age acceleration) predict all-cause mortality independently of chronological age and traditional risk factors. It remains unclear how epigenetic age acceleration is associated with cardiovascular disease risk and subclinical atherosclerosis. Hypothesis: Higher epigenetic age acceleration is associated prospectively with greater risk of coronary heart disease (CHD), heart failure (HF), and peripheral arterial disease (PAD) and cross-sectionally with higher carotid intima-medial thickness (IMT). Methods: Age acceleration of blood was estimated by two published methods (Horvath and Hannum) using DNA methylation levels (Illumina 450K array) at 353 and 71 CpG sites in African Americans of the Atherosclerosis Risk in Communities study in 1990-95 (baseline). Among those without prevalent disease at baseline, Cox and linear regression models were used to estimate the association of age acceleration with incident cardiovascular events occurring through 2013 and with carotid IMT cross-sectionally at baseline. Results were stratified by follow-up time for HF due to violation of the proportional hazards assumption. Results: Participants [mean baseline age: 57 years (range: 47-72)] were followed prospectively for a mean 17 years. In fully-adjusted models (Figure), a 1 SD increment in Hannum epigenetic age acceleration was associated with 15-31% greater hazard of incident cardiovascular outcomes, except for HF in later follow-up. Associations using Horvath age acceleration were similar, except it was not associated with myocardial infarction. Cross-sectionally, a 1 SD increment in each age acceleration measure was associated with 0.01 higher baseline carotid IMT (both P ≤ 0.01). Conclusion: This study of African Americans provides evidence that epigenetic age acceleration is associated with greater risk of CHD, HF, and PAD events and higher extent of carotid atherosclerosis, independently of traditional risk factors.

CT screened arterial calcification as a risk factor for mortality after trauma.

BackgroundArterial calcification on Computerised Tomography (CT) is a marker of cardiovascular disease. It is predictive of future adverse cardiac events and mortality in many disease states. The incidence of arterial disease and its impact on outcomes of the injured is not known. The objectives of this study were to describe the incidence of arterial calcification in trauma patients, and establish its impact on mortality.MethodsA retrospective cohort study of all injured patients aged over 45 years presenting to a major trauma centre over a 34-month period. The presence and quantity of coronary, aortic and abdominal arterial calcification on admission CT scans of the chest, abdomen and pelvis was established, and the association between cardiovascular disease and in-hospital mortality following trauma was determined.ResultsFive hundred ninety-one patients were included in the study. Cardiac calcium was visible on 432 (73 %) scans, and abdominal arterial calcification on 472 (79.9 %). Fifty (8.5 %) patients died. Patients with Superior Mesenteric (SMA) and Common Iliac Artery calcification had a significantly higher mortality than those without (p < 0.01).In multivariarate analysis, only SMA calcification was independently associated with mortality (OR 2.462, 95 % CI 1.08–5.60, p = 0.032). Coronary calcium demonstrated no independent statistical relationship with death (Left Anterior Descending Artery OR 1.189, 95 % CI 0.51–2.78, Circumflex OR 1.290, 95 % CI 0.56–2.98, Right Coronary Artery OR 0.483, 95 % CI 0.21–1.10).DiscussionThis study has demonstrated that the identification of arterial calcification on admission CT scans of trauma patients is possible. Calcification was common, and present in around three-quarters of injured individuals over the age of 45 years. SMA calcium was an independent predictor of mortality. However, whilst the presence of arterial calcium demonstrated a tendency towards lower survival, this association was not significant in other territories, including the coronary arteries. Future studies should investigate further the association and pathophysiology linking SMA disease and mortality in trauma, in addition to the relationship between longer tem survival, adverse cardiac events and arterial calcification in injured patients.ConclusionsArterial calcification can be reliably identified on trauma CT scans, and is common in injured patients. Abdominal vascular calcification appears to be a better predictor of mortality than coronary artery disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-016-0317-1) contains supplementary material, which is available to authorized users.

THE RISK OF CORONARY ARTERY DISEASE DEVELOPMENT IN PATIENTS WITH ANKYLOSING SPONDYLITIS (BECHTEREW’S DISEASE) AND PSORIATIC ARTHRITIS: A 10-YEAR PROSPECTIVE FOLLOW-UP STUDY

Objective: assessment of coronary artery disease (CAD) incidence among patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) without manifestation of cardiovascular diseases. Materials and methods. We analyzed the data of 10-year prospective follow-up of the patient with AS (n = 278), psoriatic arthritis (n = 85) and healthy controls (n = 150) without any cardiovascular diseases. All groups were comparable in regard to cardiovascular risk factors. During these 10 years all new cases of CAD (verified by cardiologist) in the study population were tracked. Results. New cases of CAD were fixed in 64 out of 278 patietns with AS and in 16 out of 150 controls (p = 0.0017). Using log-rank MantelCox test and logrank test for trend we demonstrated statistically significant differences in CAD incidence between patients without spondyloarthritis (SpA) and patients with AS and PsA (p 0.05). Conclusion. The risk of exertional stenocardia in patients with AS was not higher than that in individuals without SpA. However, patients with AS have higher risk of myocardial infarction than those without SpA. PsA patients have increased risk of CAD development comparing to healthy controls and individuals with AS.

Tibial-pedal arterial access &amp; retrograde interventions for advanced peripheral arterial disease &amp; critical limb ischemia

The incidence of peripheral arterial disease is rising thanks to increasing rates of obesity, diabetes, hypertension and failed attempts at controlling tobacco abuse. Advanced peripheral arterial disease and critical limb ischemia represent the terminal stages and carry high amputation and mortality rates. Evolving technology and understanding of the disease process have introduced newer therapeutic modalities and approaches to peripheral vascular interventions. Among these, retrograde tibial-pedal access and minimally invasive retrograde interventions are gaining momentum as new adopters are witnessing the safety and improved outcomes (evidenced by the increased success rate of previously failed attempts at crossing complex occlusions via the traditional antegrade approach). The shift toward less invasive approaches has led to increased endovascular interventions and decreased amputation rates.

Postoperative Tachyarrhythmias: On-Pump versus Off-Pump Coronary Artery Bypass Grafting

Objective. Tachyarrhythmias, after coronary artery bypass graft (CABG) surgery, develop in 11%–40% of patients. Surgery technique (on-pump or off-pump) might affect incidence of post-CABG tachyarrhythmias. Methods. The study included 60 patients undergoing CABG (≥2 grafts) with left ventricle ejection fraction (LV EF) &gt;40%. Patients were divided into two groups equally: group A (on-pump) and group B (off-pump). Patients were subjected to electrocardiographic monitoring (7 days postoperatively), transthoracic echocardiography, with recording of surgical details and complications. Results. Data collected between December 2012 and May 2013 showed no significant difference between two groups regarding incidence of postoperative tachyarrhythmias with statistically significant higher incidence of supraventricular tachycardia in group B (P&lt;0.05) and a trend towards higher incidence of atrial fibrillation in group A. Patients who developed postoperative tachyarrhythmias in group A showed higher prevalence of family history of coronary artery disease and higher incidence of postoperative chest infections (P&lt;0.05), while those in group B showed higher mean LV EF (pre- and postoperatively) (P&lt;0.05). Data were statistically described in terms of mean ± standard deviation. Comparison of numerical and categorical variables was done using Student’s t- and Chi-square tests, respectively. Conclusion. Adopting off-pump CABG technique is not associated with less incidence of post-operative tachyarrhythmias, as compared to on-pump technique.

Circulation Editors’ Picks

<i>Circulation</i> Editors’ Picks

Prevalence of Coronary Heart Disease among Non-Smokers with Type 2 Diabetes Mellitus and Metabolic Syndrome Defined By NCEPATP 111 (National Cholesterol Education Programme Adult Treatment Panel 111)

Coronary Artery Disease (CAD) incidence varies according to certain risks; patients with pre-existing cardiovascular heart disease who later develop diabetes mellitus (DM) have the greatest risk, and non-diabetic patients with CAD, diabetic patients without CAD, and patients with metabolic syndrome (MetS) the next three high risk categories. Insulin resistance, a major feature in both DM and MetS probably causes atherogenic dyslipidaemia. Objectives: (1) to determine the prevalence of MetS and DM in the study population, (2) to determine the prevalence of Coronary Artery Disease (CAD) in DM with MetS (DM+/MetS+), in DM alone (DM+/MetS-), MetS alone (Mets+/DM-) and in ‘normal’ group (DM-/MetS-), and (3) to determine the prevalence of MetS in DM patients. Results: 62.1% of the study population had MetS, 44.7% had DM, 83.6% had both MetS and DM. 18.6% had CAD. CAD was seen in 25.2% of DM+/MetS+, 19.1% of MetS+/DM-, 14.3% of DM+/MetS-, and 11.6% of MetS-/DMpatients. DM+/MetS+ group had the highest association with CAD OR= 2.19, CI (1.43-3.35), DM-/MetS- group the lowest association OR=0.45, CI (0.27-0.73), and DM+/MetS- (OR=0.69, CI (0.28-1.73) and MetS+/DM- (OR=0.94, CI (0.57- 1.58) had no significant association with CAD. Conclusion: Only DM+/MetS+ patients had a high risk of developing CAD. Risk of CAD in patients with MetS+/ DM- and DM+/MetS- was not statistically significant in multivariate analysis, while the group with neither, MS-/DM-, had the lowest risk of developing CAD.

Bone Marrow Mononuclear Stem Cell Transplant in Acute and Chronic Arterial Insufficiency in Rabbits

Introduction: There is a high incidence of Peripheral Obstructive Arterial Disease (POAD) in patients with atherosclerosis. In more complex cases for which surgical revascularization is not possible, the only option involves clinical treatment that in the majority of cases evolves to amputation of the limb. Transplant of mononuclear stem cells from bone marrow has presented favorable results in chronic obstructions. Objective: To perform a functional analysis of the effect of bone marrow mononuclear stem cell transplant on acute arterial occlusion immediately and 48 hours after occlusion, comparing between groups and with controls. Materials and methods: Twenty New Zealand rabbits were anesthetized with ketamine and xylazine (50 mg/ kg) and underwent occlusion of the right iliac artery. Those animals that presented absence of arterial flow after ligation were included in the study. These animals were then randomized and divided into four groups: Group 1(n=5) control of acute ischemia group–injection of saline solution, Group 2(n=5) control of chronic ischemia–injection of saline solution 48hrs after occlusion. Group 3(n=5) transplant of stem cell in acute ischemia group, and Group 4(n=5) transplant of stem cells in the chronic ischemia group, 48hrs after occlusion. The animals were evaluated by the Tarlov’s movement scale, degree of tissue ischemia, and degree of modified ischemia on the seventh, fourteenth and thirtieth day after arterial occlusion. This evaluation was performed in a blind and randomized fashion by two different observers. The animals underwent another vascular Doppler exam on the thirtieth day after arterial occlusion. Results: All animals were considered homogeneous in the pre-transplant period. No statistical differences were identified between groups G1 and G3 (p=109) with respect to Tarlov scale. Regarding the intergroup analysis, a clinical improvement was observed in Group 4 when compared to Groups 1, 2, and 3, p=0.003, p=0.0025, and p=0.055 respectively, on the thirtieth day after occlusion. No significant difference was observed for the degree of ischemia and modified ischemia parameters after transplant. Conclusion: Clinical improvement in the chronic ischemia group receiving cell transplant of mononuclear stem cells was observed in comparison to the control group and in relationship to the acute ischemia group, suggesting a functional improvement in the affected limb.

Sudden Cardiac Death in Asian Prospects

Sudden Cardiac Death of Asian Prospects Young-Hoon Kim, MD. Cardiology Division, Korea University Medical Center, Seoul, Korea Due to the geographic, economical, and cultural differences in different countries of Asia, there are signifi cant regional variations in coronary artery disease (CAD) incidence. Currently, CAD has already become the major type of heart disease. It can be expected that the incidence of sudden cardiac death (SCD) will increase and become a heavy healthcare burden. However, there are very few studies of the epidemiology and the clinical prevention and treatment of SCD in Asia. Low rate of cardiopulmonary resuscitation (CPR) by lay person or family members at home, delayed resuscitation, and limited public access automated defibrillator (AED) resulted in very low rate of survival to discharge in out of hospital SCD patients in Asia. Large-scale epidemiologic and genetic studies are required to clarify SCD high-risk patients and SCD genes in Asia. Increased awareness of SCD by public education is required and community-based resuscitation program is an effective means to increase the survival to discharge of the victims of SCD. Establish extensive public availability of AEDs. ICDs, especially as the primary prevention for high-risk SCD patients, are of great importance. Prospective, multicenter trials designed to directly address the problem of SCD in Asia are warranted to establish.

Elevated plasma fibrin D-dimer as a risk factor for vascular dementia: the Three-City cohort study.

Hemostatic biomarkers have been associated with coronary heart disease (CHD) and stroke. However, few studies have investigated these associations in the elderly. Moreover, vascular factors may be involved in dementia. Data on the relationship between hemostatic biomarkers and dementia remain scarce. Our study aimed to investigate the relationship between hemostatic biomarkers and the risk of CHD, stroke and dementia in an elderly population. In the Three-City cohort study including men and women aged > or = 65, we investigated the association of fibrinogen, D-dimer and von Willebrand factor with the 4-year incidence of arterial disease (CHD, n = 199; and stroke, n = 111) and dementia (n = 218). Measurements were performed for all cases and for a random sample of the entire cohort (n = 1254). Hazards ratios (HR) compared the last quintile with the first of each parameter's distribution and P-values refer to the test for linear trend across quintiles. Elevated fibrinogen was associated with the risk of CHD and myocardial infarction (HR = 2.20, P < 0.05 and 2.45 P < 0.05, respectively). Moreover, high D-dimer was associated with the risk of CHD among younger subjects (aged < 75, HR = 3.64, P < 0.01) but not older subjects (P for interaction = 0.01). Furthermore, the risk of vascular dementia (VaD) increased with D-dimer level (HR = 3.05, P < 0.01). In the elderly, elevated fibrinogen and D-dimer levels were associated with incident arterial disease. In addition, high D-dimer level could represent a new risk factor for VaD.

Abstract 4223: Low Adiponectin Levels Are an Independent Predictor of Mixed and Non-Calcified Coronary Atherosclerotic Plaques

We sought to examine the relationship of adiponectin with coronary atherosclerotic plaque morphology in patients with stable typical or atypical chest pain. There is increasing recognition that lesion composition rather than size determines the acute complications of atherosclerotic disease. Low serum adiponectin levels are associated with coronary artery disease and future incidence of acute coronary syndrome. The impact of adiponectin on lesion composition still remains to be determined. Serum adiponectin levels were determined in 303 patients with stable typical or atypical chest pain, who underwent dual-source multi-slice CT-angiography to exclude coronary artery stenosis. Atherosclerotic plaques were classified as calcified, mixed or non-calcified plaques. In bivariate analysis adiponectin levels were inversely correlated with total coronary plaque burden (r=−0.22, p&lt;0.0001), mixed (r=−0.20, p=0.0007) and non-calcified plaques (r=−0.18, p=0.003). No correlation was seen with calcified plaques (r=−0.05, p=0.39). In a fully adjusted multivariate model containing age, sex, body mass index, hypertension, diabetes mellitus, smoking, family history of coronary artery disease, LDL-cholesterol, HDL-cholesterol, triglycerides, hsCRP levels, medication and pericardial adipose tissue volume, adiponectin levels remained predictive of total plaque burden (estimate: −0.035, 95% CI: −0.051 to −0.019, p&lt;0.0001), mixed (estimate: −0.083, 95% CI: −0.127 to −0.039, p=0.0002) and non-calcified plaques (estimate: −0.076, 95% CI: −0.114 to −0.038, p=0.0001). Since the majority of coronary plaques were calcified plaques, adiponectin levels account for only 3% of the variability in total plaque number. In contrast, adiponectin accounts for approximately 20% of the variability in mixed and non-calcified plaque burden. Adiponectin levels predict mixed and non-calcified coronary atherosclerotic plaque burden. Low adiponectin levels may contribute to coronary plaque vulnerability and may thus play a role in the pathophysiology of acute coronary syndrome.

Mo-P4:271 Plasma heparin cofactor II activity is a predictor for incidence of peripheral arterial disease in patients with cardiovascular risk factors

Mo-P4:271 Plasma heparin cofactor II activity is a predictor for incidence of peripheral arterial disease in patients with cardiovascular risk factors

The incidence of peripheral arterial disease at long term follow-up is higher in diabetic than in non-diabetic patients: A review of recent epidemiological studies

The incidence of peripheral arterial disease at long term follow-up is higher in diabetic than in non-diabetic patients: A review of recent epidemiological studies