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Peripheral artery disease in patients with type 2 diabetes
Journal of Diabetes and Its Complications 28 (2014) 912–914
Contents lists available at ScienceDirect
Journal of Diabetes and Its Complications journal homepage: WWW.JDCJOURNAL.COM
Peripheral artery disease in patients with type 2 diabetes
To the Editor: We congratulate Eshcol et al on their study on the prevalence, development and progression of peripheral artery disease (PAD) in Asian Indian patients with type 2 diabetes mellitus (T2DM) (Eshcol, Jebarani, Anjana, Mohan, & Pradeep, 2014). Non-alcoholic fatty liver disease (NAFLD) and hyperuricemia have been associated with elevated cardiovascular (CV) risk (Athyros, Katsiki, & Karagiannis, 2013; Katsiki, Athyros, Karagiannis, & Mikhailidis, 2011). These metabolic abnormalities may be present in patients with T2DM, further increasing the risk for diabetic complications, including PAD (Katsiki, Papanas, Fonseca, Maltezos, & Mikhailidis, 2013; Targher & Byrne, 2013). In this context, it would be useful to know the liver enzymes activities and serum uric acid levels both at baseline and follow-up in the Eschol et al population. Other vascular markers could also be relevant such as microalbuminuria and C-reactive protein (Chuengsamarn, Rattanamongkolgul, & Jirawatnotai, 2014; van Wijk, Boekholdt, Wareham, et al., 2013). Certain drugs may influence PAD incidence or outcomes, including antihypertensive and lipid-lowering agents (Katsiki, Athyros, Karagiannis, & Mikhailidis, 2014; Lane & Lip, 2013). In this context, perindopril + amlodipine therapy was more beneficial in terms of PAD prevention compared with atenolol + thiazide treatment in T2DM patients in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) (Ostergren, Poulter, Sever, ASCOT investigators, et al., 2008). Furthermore, ramipril significantly reduced the risk of CV morbidity and all-cause mortality compared with placebo in PAD patients included in the Heart Outcomes Prevention Evaluation (HOPE) study (Ostergren et al., 2004). Similarly, lipid lowering was associated with fewer new clinically evident PAD cases as shown in the Program on the Surgical Control of the Hyperlipidemias (POSCH) trial (Buchwald et al., 1996). Therefore, it would be useful to know the initial antihypertensive and lipid-lowering treatment as well as any changes made in these therapies during follow-up in the Eschol et al study. A recent study (Armstrong, Chen, Westin, et al., 2014) showed that implementation of 4 guideline-recommended therapies for PAD (i.e. statins, angiotensin-converting enzyme inhibitors, aspirin and smoking cessation) led to significantly fewer major adverse CV, cerebrovascular or limb events as well as deaths compared with adherence to b4 of the recommended therapies. Therefore, multitargeted intervention is required for the prevention of PAD development and progression in T2DM patients.
Declaration of interest: This letter was written independently; no company or institution supported the authors financially or by providing a professional writer. Some of the authors have given talks, attended conferences and participated in trials and advisory boards sponsored by various pharmaceutical companies.
1056-8727/© 2014 Elsevier Inc. All rights reserved
References Armstrong, E. J., Chen, D. C., Westin, G. G., Singh, S., McCoach, C. E., Bang, H., et al. (2014). Adherence to guideline-recommended therapy is associated with decreased major adverse cardiovascular events and major adverse limb events among patients with peripheral arterial disease. Journal of the American Heart Association, 3, e000697. Athyros, V. G., Katsiki, N., & Karagiannis, A. (2013). Nonalcoholic fatty liver disease and severity of cardiovascular disease manifestations. Angiology, 64, 572–575. Buchwald, H., Bourdages, H. R., Campos, C. T., Nguyen, P., Williams, S. E., & Boen, J. R. (1996). Impact of cholesterol reduction on peripheral arterial disease in the Program on the Surgical Control of the Hyperlipidemias (POSCH). Surgery, 120, 672–679. Chuengsamarn, S., Rattanamongkolgul, S., & Jirawatnotai, S. (2014). Association between serum uric acid level and microalbuminuria to chronic vascular complications in Thai patients with type 2 diabetes. Journal of diabetes and its complications, 28, 124–129. Eshcol, J., Jebarani, S., Anjana, R. M., Mohan, V., & Pradeep, R. (2014). Prevalence, incidence and progression of peripheral arterial disease in Asian Indian type 2 diabetic patients. Journal of Diabetes and its Complications, 28, 627–631. Katsiki, N., Athyros, V. G., Karagiannis, A., & Mikhailidis, D. P. (2011). Hyperuricaemia and non-alcoholic fatty liver disease (NAFLD): a relationship with implications for vascular risk? Current Vascular Pharmacology, 9, 698–705. Katsiki, N., Athyros, V. G., Karagiannis, A., & Mikhailidis, D. P. (2014). The role of statins in the treatment of type 2 diabetes mellitus: an update. Current pharmaceutical design, 20(22), 3665–3674. Katsiki, N., Papanas, N., Fonseca, V. A., Maltezos, E., & Mikhailidis, D. P. (2013). Uric acid and diabetes: is there a link? Current Pharmaceutical Design, 19, 4930–4937. Lane, D. A., & Lip, G. Y. (2013). Treatment of hypertension in peripheral arterial disease. Cochrane database of systematic reviews, 12, CD003075. Ostergren, J., Poulter, N. R., Sever, P. S., Dahlöf, B., Wedel, H., Beevers, G., et al. ASCOT investigators(2008). The Anglo-Scandinavian Cardiac Outcomes Trial: blood pressure-lowering limb: effects in patients with type II diabetes. Journal of hypertension, 26, 2103–2111. Ostergren, J., Sleight, P., Dagenais, G., Danisa, K., Bosch, Qilong, Y., et al. (2004). Impact of ramipril in patients with evidence of clinical or subclinical peripheral arterial disease. European heart journal, 25, 17–24. Targher, G., & Byrne, C. D. (2013). Clinical review: nonalcoholic fatty liver disease: a novel cardiometabolic risk factor for type 2 diabetes and its complications. The Journal of clinical endocrinology and metabolism, 98, 483–495. van Wijk, D. F., Boekholdt, S. M., Wareham, N. J., Ahmadi-Abhari, S., Kastelein, J. J., Stroes, E. S., et al. (2013). C-reactive protein, fatal and nonfatal coronary artery disease, stroke, and peripheral artery disease in the prospective EPIC-Norfolk cohort study. Arteriosclerosis, Thrombosis, and Vascular Biology, 33, 2888–2894.
Niki Katsiki Vasilios G. Athyros Asterios Karagiannis Second Propedeutic Department of Internal Medicine Medical School, Aristotle University of Thessaloniki Hippocration Hospital, Thessaloniki, Greece Dimitri P. Mikhailidis Department of Clinical Biochemistry (Vascular Disease Prevention Clinics) Royal Free Hospital campus, University College London Medical School University College London (UCL), London NW3 2QG, UK ⁎Corresponding author at: Dept. of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School University College London (UCL), Pond Street, London NW3 2QG, UK Tel.: +44 20 7830 2258; fax: +44 20 7830 2235 E-mail address: [email protected] http://dx.doi.org/10.1016/j.jdiacomp.2014.06.002
Contents lists available at ScienceDirect
Journal of Diabetes and Its Complications journal homepage: WWW.JDCJOURNAL.COM
Peripheral artery disease in patients with type 2 diabetes
To the Editor: We congratulate Eshcol et al on their study on the prevalence, development and progression of peripheral artery disease (PAD) in Asian Indian patients with type 2 diabetes mellitus (T2DM) (Eshcol, Jebarani, Anjana, Mohan, & Pradeep, 2014). Non-alcoholic fatty liver disease (NAFLD) and hyperuricemia have been associated with elevated cardiovascular (CV) risk (Athyros, Katsiki, & Karagiannis, 2013; Katsiki, Athyros, Karagiannis, & Mikhailidis, 2011). These metabolic abnormalities may be present in patients with T2DM, further increasing the risk for diabetic complications, including PAD (Katsiki, Papanas, Fonseca, Maltezos, & Mikhailidis, 2013; Targher & Byrne, 2013). In this context, it would be useful to know the liver enzymes activities and serum uric acid levels both at baseline and follow-up in the Eschol et al population. Other vascular markers could also be relevant such as microalbuminuria and C-reactive protein (Chuengsamarn, Rattanamongkolgul, & Jirawatnotai, 2014; van Wijk, Boekholdt, Wareham, et al., 2013). Certain drugs may influence PAD incidence or outcomes, including antihypertensive and lipid-lowering agents (Katsiki, Athyros, Karagiannis, & Mikhailidis, 2014; Lane & Lip, 2013). In this context, perindopril + amlodipine therapy was more beneficial in terms of PAD prevention compared with atenolol + thiazide treatment in T2DM patients in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) (Ostergren, Poulter, Sever, ASCOT investigators, et al., 2008). Furthermore, ramipril significantly reduced the risk of CV morbidity and all-cause mortality compared with placebo in PAD patients included in the Heart Outcomes Prevention Evaluation (HOPE) study (Ostergren et al., 2004). Similarly, lipid lowering was associated with fewer new clinically evident PAD cases as shown in the Program on the Surgical Control of the Hyperlipidemias (POSCH) trial (Buchwald et al., 1996). Therefore, it would be useful to know the initial antihypertensive and lipid-lowering treatment as well as any changes made in these therapies during follow-up in the Eschol et al study. A recent study (Armstrong, Chen, Westin, et al., 2014) showed that implementation of 4 guideline-recommended therapies for PAD (i.e. statins, angiotensin-converting enzyme inhibitors, aspirin and smoking cessation) led to significantly fewer major adverse CV, cerebrovascular or limb events as well as deaths compared with adherence to b4 of the recommended therapies. Therefore, multitargeted intervention is required for the prevention of PAD development and progression in T2DM patients.
Declaration of interest: This letter was written independently; no company or institution supported the authors financially or by providing a professional writer. Some of the authors have given talks, attended conferences and participated in trials and advisory boards sponsored by various pharmaceutical companies.
1056-8727/© 2014 Elsevier Inc. All rights reserved
References Armstrong, E. J., Chen, D. C., Westin, G. G., Singh, S., McCoach, C. E., Bang, H., et al. (2014). Adherence to guideline-recommended therapy is associated with decreased major adverse cardiovascular events and major adverse limb events among patients with peripheral arterial disease. Journal of the American Heart Association, 3, e000697. Athyros, V. G., Katsiki, N., & Karagiannis, A. (2013). Nonalcoholic fatty liver disease and severity of cardiovascular disease manifestations. Angiology, 64, 572–575. Buchwald, H., Bourdages, H. R., Campos, C. T., Nguyen, P., Williams, S. E., & Boen, J. R. (1996). Impact of cholesterol reduction on peripheral arterial disease in the Program on the Surgical Control of the Hyperlipidemias (POSCH). Surgery, 120, 672–679. Chuengsamarn, S., Rattanamongkolgul, S., & Jirawatnotai, S. (2014). Association between serum uric acid level and microalbuminuria to chronic vascular complications in Thai patients with type 2 diabetes. Journal of diabetes and its complications, 28, 124–129. Eshcol, J., Jebarani, S., Anjana, R. M., Mohan, V., & Pradeep, R. (2014). Prevalence, incidence and progression of peripheral arterial disease in Asian Indian type 2 diabetic patients. Journal of Diabetes and its Complications, 28, 627–631. Katsiki, N., Athyros, V. G., Karagiannis, A., & Mikhailidis, D. P. (2011). Hyperuricaemia and non-alcoholic fatty liver disease (NAFLD): a relationship with implications for vascular risk? Current Vascular Pharmacology, 9, 698–705. Katsiki, N., Athyros, V. G., Karagiannis, A., & Mikhailidis, D. P. (2014). The role of statins in the treatment of type 2 diabetes mellitus: an update. Current pharmaceutical design, 20(22), 3665–3674. Katsiki, N., Papanas, N., Fonseca, V. A., Maltezos, E., & Mikhailidis, D. P. (2013). Uric acid and diabetes: is there a link? Current Pharmaceutical Design, 19, 4930–4937. Lane, D. A., & Lip, G. Y. (2013). Treatment of hypertension in peripheral arterial disease. Cochrane database of systematic reviews, 12, CD003075. Ostergren, J., Poulter, N. R., Sever, P. S., Dahlöf, B., Wedel, H., Beevers, G., et al. ASCOT investigators(2008). The Anglo-Scandinavian Cardiac Outcomes Trial: blood pressure-lowering limb: effects in patients with type II diabetes. Journal of hypertension, 26, 2103–2111. Ostergren, J., Sleight, P., Dagenais, G., Danisa, K., Bosch, Qilong, Y., et al. (2004). Impact of ramipril in patients with evidence of clinical or subclinical peripheral arterial disease. European heart journal, 25, 17–24. Targher, G., & Byrne, C. D. (2013). Clinical review: nonalcoholic fatty liver disease: a novel cardiometabolic risk factor for type 2 diabetes and its complications. The Journal of clinical endocrinology and metabolism, 98, 483–495. van Wijk, D. F., Boekholdt, S. M., Wareham, N. J., Ahmadi-Abhari, S., Kastelein, J. J., Stroes, E. S., et al. (2013). C-reactive protein, fatal and nonfatal coronary artery disease, stroke, and peripheral artery disease in the prospective EPIC-Norfolk cohort study. Arteriosclerosis, Thrombosis, and Vascular Biology, 33, 2888–2894.
Niki Katsiki Vasilios G. Athyros Asterios Karagiannis Second Propedeutic Department of Internal Medicine Medical School, Aristotle University of Thessaloniki Hippocration Hospital, Thessaloniki, Greece Dimitri P. Mikhailidis Department of Clinical Biochemistry (Vascular Disease Prevention Clinics) Royal Free Hospital campus, University College London Medical School University College London (UCL), London NW3 2QG, UK ⁎Corresponding author at: Dept. of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School University College London (UCL), Pond Street, London NW3 2QG, UK Tel.: +44 20 7830 2258; fax: +44 20 7830 2235 E-mail address: [email protected] http://dx.doi.org/10.1016/j.jdiacomp.2014.06.002