Atherosclerosis peripheral artery

Clarkson TB, Ethun KF, Chen H, Golden D, Floyd E, Appt SE. Effects of bazedoxifene alone and with conjugated equine estrogens on coronary and peripheral artery atherosclerosis of postmenopausal monkeys. Menopause 2013 20(3) 274-81. 

The response-to-injury hypothesis states that risk factors such as oxidized LDL, mechanical injury to the endothelium, excessive homocysteine, immunologic attack, or infection-induced changes in endothelial and intimal function lead to endothelial dysfunction and a series of cellular interactions that culminate in atherosclerosis. The eventual clinical outcomes may include angina, myocardial infarction, arrhythmias, stroke, peripheral arterial disease, abdominal aortic aneurysm, and sudden death. 

In addition to coronary sclerosis, evidence is accumulating that high Lp(a) levels may be important in the development of cerebrovascular and peripheral arterial disease, as well (J6, T8, U2). Lp(a) levels not only correlated well with clinical endpoints such as transient ischemic attack and cerebral infarction, but also were associated with the extent and severity of carotid atherosclerosis, as assessed by bidirectional Doppler ultrasound (K23, M33, Z2). 

It is well-established that an elevated level of cholesterol, particnlarly that carried largely in the form of LDLs, is an independent risk factor for the development of atherosclerosis and its sequelae, including coronary artery disease (leading to heart attacks), strokes, and peripheral arterial disease. 

Unlabeled Uses Treatment of atherosclerosis, gangrene, pain due to severe peripheral arterial occlusive disease, pulmonary hypertension... 

Peripheral artery disease (PAD) patients usually feel leg pain when walking, which is caused by insufficient blood flow to keep up with energy demand. The P MRS data collected in a PAD patient group showed prolonged PCr recovery rate (or time constants) in the calf muscle after exhaustive exercise, suggesting the transition from anaerobic to aerobic energy metabolism is delayed due to impaired oxygen supply or mitochondria fimction caused by atherosclerosis. ... 

Atherosclerosis can result in ischemia of peripheral muscles just as coronary artery disease causes cardiac ischemia. Pain (claudication) occurs in skeletal muscles, especially in the legs, during exercise and disappears with rest. Although claudication is not immediately life-threatening, peripheral artery disease is associated with increased mortality, can severely limit exercise tolerance, and may be associated with chronic ischemic ulcers and susceptibility to infection. 

The thrombotic disorders include atherothrombosis, endothelial dysfunction, hypercoagulable states, and the thrombophilias. Atherothrombosis or atherosclerosis is a systemic disease of the vessel wall occuring in the aorta, carotid, coronary, and peripheral arteries. The associated inflammatory response is mediated by macrophages and T-lymphocytes with continued smooth muscle cell proliferation, The levels of endothelin-l (ET-I), an extremely potent... 

Pittler MH, Ernst E, Complementary therapies for peripheral arterial disease systematic review. Atherosclerosis 2005 181(1) 1-7. Epub 2005 Mar 3 I,... 

T9. Toth, L., and Koenig, W., Hypoalpha-hyperbeta-lipoproteinemia in a patient with coronary artery disease and occlusive peripheral arterial disease. Atherosclerosis 42,121-124... 

Chronic inflammation is an important component in the development and progression of atherosclerosis, and numerous epidemiological studies have demonstrated, that increased serum CRP concentrations are positively associated with a risk of future coronary events, such as coronary artery disease, cerebrovascular disease, or peripheral arterial disease/ " It has also been shown to be predictive of future events in patients with acute coronary syndromes and in patients with stable angina and coronary artery stents. 

Ridker PM, Stampfer MJ, et al. Novel risk factors for systemic atherosclerosis a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein (a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA 2001 285 2481-5. 

Aberrant thrombus formation and deposition on blood vessel walls imderlies the pathogenesis of acute cardiovascular disease states which remain the principal cause of morbidity and mortality in the industrialized world [1,2,3]. Plasma proteins, proteases and specific cellular receptors that participate in hemostasis have emerged as important risk considerations in thrombosis and thromboembolic disorders. The clinical manifestations of the above disease states include acute coronary artery and cerebrovascular syndromes, peripheral arterial occlusion, deep vein thrombosis and pulmonary/renal embolism [3]. The most dilabilitating acute events precipitated by these disorders are myocardial infarction and stroke. In addition, the interplay between hemostatic factors and hypertension (4) or atherosclerosis (5) dramatically enhances the manifestation of these pathologic states. 

The peripheral vasculature is considered a target organ. Physical examination of the systemic vasculature can detect evidence of atherosclerosis, which may present as bruits (in the aortic, abdominal, and peripheral arteries), distended veins, diminished or absent peripheral arterial pulses, or lower extremity edema. Peripheral arterial disease is a clinical condition that can result from atherosclerosis, which is accelerated in hypertension. Other cardiovascular risk factors (e.g., smoking) can increase the hkelihood of peripheral arterial disease as well as all other forms of target-organ damage. 

The efficacy of clopidogrel as an antiplatelet agent in atherothrombotic disorders was demonstrated in the CAPRIE trial. In this study of more than 19,000 patients with a history of either myocardial infarction (MI), stroke, or peripheral arterial disease (PAD), clopidogrel 75 mg/day was compared with aspirin 325 mg/day for its ability to decrease MI, stroke, or cardiovascular death. In the final analysis, clopidogrel was slightly (8% relative risk reduction [RRR]) more effective than aspirin (p =. 043) and had a similar incidence of adverse effects. It is not associated with the blood dyscrasias (neutropenia) common with its congener, ticlopidine, and is used widely in patients with atherosclerosis. 

Criqui MH. Systemic atherosclerosis risk and the mandate for intervention in atherosclerotic peripheral arterial disease. Am J Cardiol 2001 88 43J-47J. 

The therapeutic indications for garlic bulb are prophylaxis of atherosclerosis treatment of elevated blood lipid levels, insufficiently influenced by diet improvement of the circulation in peripheral arterial vascular disease and respiratory infections and catarrhal conditions. 

Congestive heart failure is common and is related to fluid overload, hypertension, or atherosclerosis. Some workers have postulated a uremic cardiomyopathy. The enhancement by parathormone of cellular calcium uptake may contribute to myocardial calcification, degeneration, and fibrosis (M26). There is a higher incidence of calcification of the aortic and mitral valves, as well as of visceral and peripheral arteries in association with uremic hyperparathyroidism (M13). In addition to PTH, middle molecules (B19), phenols (L3), guanidino-succinic acid (K5), or cobalt (P6) may contribute to the observed cardiotoxicity in vitro of uremic serum. 

Optrin has demonstrated a reduction of atherosclerosis by eliminating inflammatory cells and is actually in Phase II studies for the primary treatment of peripheral artery disease and for the prevention of restenosis following angioplasty [71]. 

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