Korean Journal of Family Medicine

"Peripheral Arterial Disease"

Original Articles

Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study: Tolga Vural, Makbule Neslişah Tan, Mehtap Kartal, Azize Dilek Güldal; Korean J Fam Med 2020;41(1):61-67. Published online May 13, 2019; DOI: https://doi.org/10.4082/kjfm.18.0066

Abstract
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Background
Peripheral arterial disease (PAD) can progress silently without any clinical symptoms. Ankle-brachial index (ABI) is the recommended method used in primary care. We aimed to determine the prevalence of PAD and its related risk factors in primary care.
Methods
In this cross-sectional study, 250 participants aged ≥45 years were recruited randomly from the registered patients of family health center in a district of Izmir, Turkey. Patients’ demographic data, PAD symptoms, and PAD risk factors were obtained. The PAD group consisted of patients with ABI levels <0.9; the non-compressible artery (NCA) group consisted of patients with ABI levels >1.3.
Results
The prevalence of PAD was 17.6% (22.5% in women and 11.1% in men), while that of NCA was 15.2% (12.7% in women and 25.0% in men). About 27.3% and 54.5% of patients with PAD did not have claudication and problems with walking distance, respectively. Of the NCA patients, 15.8% had problems with walking distance and 39.5% had claudication. Regression analysis revealed two predictors of PAD (age ≥65 years: odds ratio [OR], 3.51; 95% confidence interval [CI], 1.65–7.47; claudication: OR, 3.41; 95% CI, 1.58–7.39) and three predictors of NCA (age <65 years: OR, 2.55; 95% CI, 1.01–6.45; male sex: OR, 2.40; 95% CI, 1.10–5.25; triglyceride [TG] >200 mg/dL: OR, 4.11; 95% CI, 1.58–10.67).
Conclusion
PAD had a prevalence of 17.6% and was associated with age ≥65 years and claudication. NCA had a prevalence of 15.2% and was associated with age <65 years, TG >200 mg/dL, and male sex.

Citations

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Nevra Kalkan, Mevlude Karadağ
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Halis Yılmaz, Seda Arslan Özkul, Kübra Temel Aslan, Pemra Cöbek Ünalan, Çiğdem Apaydın Kaya
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Differences in Symptom Presentation in Women and Men with Confirmed Lower Limb Peripheral Artery Disease: A Systematic Review and Meta-Analysis
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Cindy P. Porras, Martin Teraa, Michiel L. Bots, Annemarijn R. de Boer, Sanne A. E. Peters, Sander van Doorn, Robin W. M. Vernooij
Journal of Clinical Medicine.2022; 11(13): 3666. CrossRef
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Saulo Henrique Salgueiro de Aquino, Isabelle Tenório Melo, Carlos Dornels Freire de Souza, Francisco de Assis Costa
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5,842 View
117 Download
5 Web of Science
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Higher Serum Calcium Levels Are Associated with Preclinical Peripheral Arterial Disease among the Apparently Healthy Individuals: Hyung-Jin Kim, Mi-Ri Kim, Jin-Kyung Park, Yong-Jae Lee, Byoungjin Park; Korean J Fam Med 2018;39(5):279-283. Published online July 4, 2018; DOI: https://doi.org/10.4082/kjfm.17.0035

Abstract
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Background
Epidemiological studies suggest that serum calcium levels correlate with cardiovascular events. An ankle-brachial index (ABI) between 0.9 and 1.00 is a surrogate estimation of preclinical peripheral arterial disease (PAD). Prior studies have shown that an ABI of 0.9–1.0 is also associated with endothelial dysfunction. Therefore, we sought to investigate the relationship between serum calcium levels and preclinical PAD in apparently healthy Korean individuals.
Methods
We evaluated the association between serum calcium levels and preclinical PAD in 596 participants (334 males, 262 females) in a health examination program. Preclinical PAD was defined by an ABI of 0.9–1.0. Multiple logistic regression analysis was used to determine whether the serum calcium level was an independent determinant of preclinical PAD.
Results
The overall prevalence of preclinical PAD was 14.3%. The mean age was 44.0±12.5 years in the non-PAD group and 48.3±11.4 years in the preclinical PAD group (P=0.001). After adjusting for age, gender, systolic blood pressure, fasting plasma glucose, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, g-glutamyltransferase, uric acid, hypertension medication, diabetes medication, and hyperlipidemia medication, the odds ratio (95% confidence intervals) for preclinical PAD was 2.28 (1.02–5.11) with a 1-mg/dL increase in the serum calcium.
Conclusion
These findings suggest that increased serum calcium is independently and positively associated with preclinical PAD regardless of the presence of classic cardiovascular risk factors.

Citations

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Association of Klotho and FGF23 with cardiovascular outcomes in diabetic older adults with chronic limb-threatening ischemia: a prospective study
Federico Biscetti, Silvia Giovannini, Roberto Iezzi, Claudia Loreti, Pietro Caliandro, Lorenzo Biscotti, Dario Pitocco, Andrea Flex
GeroScience.2025;[Epub] CrossRef

7,930 View
102 Download
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Comparison of the Framingham Risk Score, UKPDS Risk Engine, and SCORE for Predicting Carotid Atherosclerosis and Peripheral Arterial Disease in Korean Type 2 Diabetic Patients: Hye-Ran Ahn, Min-Ho Shin, Woo-Jun Yun, Hye-Yeon Kim, Young-Hoon Lee, Sun-Seog Kweon, Jung-Ae Rhee, Jin-Su Choi, Seong-Woo Choi; Korean J Fam Med 2011;32(3):189-196. Published online March 31, 2011; DOI: https://doi.org/10.4082/kjfm.2011.32.3.189

Abstract
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Background

To compare the predictability of the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study (UKPDS) risk engine, and the Systematic Coronary Risk Evaluation (SCORE) for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.

Methods

Among 1,275 registered type 2 diabetes patients in the health center, 621 subjects with type 2 diabetes participated in the study. Well-trained examiners measured the carotid intima-media thickness (IMT), carotid plaque, and ankle brachial index (ABI). The subject's 10-year risk of coronary heart disease was calculated according to the FRS, UKPDS, and SCORE risk scores. These three risk scores were compared to the areas under the curve (AUC).

Results

The odds ratios (ORs) of all risk scores increased as the quartiles increased for plaque, IMT, and ABI. For plaque and IMT, the UKPDS risk score provided the highest OR (95% confidence interval) at 3.82 (2.36, 6.17) and at 6.21 (3.37, 11.45). For ABI, the SCORE risk estimation provided the highest OR at 7.41 (3.20, 17.18). However, no significant difference was detected for plaque, IMT, or ABI (P = 0.839, 0.313, and 0.113, respectively) when the AUCs of the three risk scores were compared. When we graphed the Kernel density distribution of these three risk scores, UKPDS had a higher distribution than FRS and SCORE.

Conclusion

No significant difference was observed when comparing the predictability of the FRS, UKPDS risk engine, and SCORE risk estimation for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.

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