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PAD Risk Factors

A study published in the June 6, 2006 issue of Circulation reports that risk factors for large-vessel peripheral arterial disease (LV-PAD) might differ from those for small-vessel peripheral arterial disease (SV-PAD). By using noninvasive tests to examine the 2 different types of PAD, the researchers found that diabetes was the only significant risk factor for SV-PAD, but several other factors, such as smoking, elevated lipids, and inflammation, contributed to the progression of LV-PAD.


In the study of 403 patients who had LV-PAD and 290 patients who had SV-PAD, the researchers assessed parameters such as blood pressure, ankle and toe brachial index, and cholesterol and triglyceride levels. They concluded that the role of active smoking and the ratio of total to high-density lipoprotein cholesterol in the progression of LV-PAD provide important new markers for this disease. With diabetes emerging as the significant indicator for SV-PAD, the evidence also suggests different pathology for the development of these 2 types of PAD.


Source: Aboyans V, Criqui MH, Denenberg JO, Knoke JD, Ridker PM, Fronek A. Risk factors for progression of peripheral arterial disease in large and small vessels. Circulation. 2006;113:2623-9.


Venous Ulcers

To examine the characteristics of refractory venous leg ulcers, French researchers retrospectively studied prognostic factors for healing in patients with this type of chronic wound. Findings of the study, which include 4 specific risk factors, were published in the April 2006 issue of Dermatologic Surgery.


The study population consisted of 20 women and 12 men with a mean age of 73.5 years. The control population comprised 64 patients, 40 women and 24 men, with a mean age of 73 years. They were followed and treated in the researchers' dermatology department between January 1993 and January 2000. Each patient in the study was compared with 2 patients matched for age and gender who presented with leg ulcers that healed normally; these controls were followed during the same period as the study patients.


The researchers concluded that 4 primary risk factors for refractory ulcer were often found in the patients studied: associated arterial disease, presence of post-thrombotic popliteal sequelae, recurrence of the ulcer, and disability.


Source: Guillaume C, Viseux V, Ramelet AA, Ganry O, Billet A, Lok C. Refractory venous leg ulcers: a study of risk factors. Dermatol Surg. 2006;32:512-9.