![]() ![]() It has been postulated that C-reactive protein rises in acute inflammationand may contribute to further atherosclerosis by stimulating macrophage uptake of low density lipoprotein cholesterol(LDL-C). Some circulating biomarkers such as C-reactive protein,cardiac troponin I, myostatin, homocystein, dimethylarginine, e.t.c have been found to be indispensable in the diagnosisand prediction of possible occurrence of CVD. These diseases have been observed to affect people of older age and havehigher susceptibility in male than the female counterparts. These diseases include hypertension, coronary arterydisease, cardiac dysrhythmias, cerebrovascular disease, valvular heart disease, cardiomyopathies, peripheral vasculardisease, and congenital cardiac abnormalities. Revascularization, endovascular or surgical, is indicated for symptoms that persist despite medical management or for limb salvage in the context of critical limb ischemia.Ĭardiovascular diseases (CVD), a group of diseases that affect the heart and blood vessels have posed high morbidityrate to humans, with the second-high mortality rate after cancer. Computed tomography or magnetic resonance angiography can also be useful in planning for revascularization. Conventional angiography is typically performed when revascularization is being considered. Cilostazol can be used as an adjunct to an exercise program. Supervised exercise increases walking distance. In the treatment of peripheral artery disease, the main goals are to reduce cardiovascular risk and improve functional capacity. Exercise testing can uncover mild disease and quantify functional capacity. Noninvasive vascular testing provides information on the presence, severity, and location of peripheral artery disease. Smoking and diabetes are the strongest risk factors. How would you evaluate and manage this case?.Key Clinical Points Peripheral Artery Disease Atherosclerotic peripheral artery disease affects more than 200 million persons worldwide, including at least 8.5 million persons in the United States, and is associated with high rates of cardiovascular events and death. On examination, the blood pressure is 126/82 mm Hg, there is a bruit over the right femoral artery, and pulses are diminished in the right leg. She has a smoking history of 50 pack-years and currently smokes eight cigarettes per day. Her medical history is notable for coronary-artery bypass surgery after a myocardial infarction at 55 years of age and for hyperlipidemia, for which she takes atorvastatin at a dose of 40 mg daily. She is able to walk no more than 50 m before having to stop because of leg pain. Her symptoms have recently progressed to involve the right calf. How would you evaluate and manage this case?.ĪB - A 61-year-old woman presents with a 3-year history of discomfort in the right thigh on exertion. N2 - A 61-year-old woman presents with a 3-year history of discomfort in the right thigh on exertion. Michael Jaff, DO, served as Guest Editor for this paper. Kadian-Dodov has no relationships relevant to the contents of this paper to disclose. Hiatt has received grant support for clinical trial research from AstraZeneca, Bayer, Janssen, GlaxoSmithKline, ReNeuron, and the National Institutes of Health. Armstrong is a consultant/advisory board member for Abbott Vascular, Medtronic, Merck, Pfizer, and Spectranetics. ![]() White serves on the research advisory board for Lutonix and Surmodics. Olin serves on the steering committee and scientific advisory board for Merck for the TRAP2 trial serves on the international steering committee for the EUCLID Trial and is a site investigator for AstraZeneca. ![]()
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