Cargando…

Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease

OBJECTIVE: Atherosclerosis expression varies across not only coronary, cerebrovascular, and peripheral arteries but also within the peripheral vascular tree. The underlying pathomechanisms of distinct atherosclerosis phenotypes in lower extremity peripheral artery disease (PAD) is poorly understood....

Descripción completa

Detalles Bibliográficos
Autores principales: Baretella, Oliver, Buser, Laura, Andres, Claudine, Häberli, Dario, Lenz, Armando, Döring, Yvonne, Baumgartner, Iris, Schindewolf, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10333498/
https://www.ncbi.nlm.nih.gov/pubmed/37441701
http://dx.doi.org/10.3389/fcvm.2023.1004003
_version_ 1785070672872996864
author Baretella, Oliver
Buser, Laura
Andres, Claudine
Häberli, Dario
Lenz, Armando
Döring, Yvonne
Baumgartner, Iris
Schindewolf, Marc
author_facet Baretella, Oliver
Buser, Laura
Andres, Claudine
Häberli, Dario
Lenz, Armando
Döring, Yvonne
Baumgartner, Iris
Schindewolf, Marc
author_sort Baretella, Oliver
collection PubMed
description OBJECTIVE: Atherosclerosis expression varies across not only coronary, cerebrovascular, and peripheral arteries but also within the peripheral vascular tree. The underlying pathomechanisms of distinct atherosclerosis phenotypes in lower extremity peripheral artery disease (PAD) is poorly understood. We investigated the association of cardiovascular risk factors (CVRFs) and atherosclerosis distribution in a targeted approach analyzing symptomatic patients with isolated anatomic phenotypes of PAD. METHODS: In a cross-sectional analysis of consecutive patients undergoing first-time endovascular recanalization for symptomatic PAD, data of patients with isolated anatomic phenotypes of either proximal (iliac) or distal (infrageniculate) atherosclerosis segregation were extracted. We performed a multivariable logistic regression model with backward elimination to investigate the association of proximal and distal PAD with CVRFs. RESULTS: Of the 637 patients (29% females) with endovascular recanalization, 351 (55%) had proximal and 286 (45%) had distal atherosclerosis. Female sex [odds ratio (OR) 0.33, 95% confidence interval (CI) 0.20–0.54, p = 0.01], active smoking (OR 0.16, 95% CI 0.09–0.28, p < 0.001), and former smoking (OR 0.33, 95% CI 0.20–0.57, p < 0.001) were associated with proximal disease. Diabetes mellitus (DM) (OR 3.25, 95% CI 1.93–5.46, p < 0.001), chronic kidney disease (CKD) (OR 1.18, 95% CI 1.08–1.28, p < 0.001), and older age (OR 1.31, 95% CI 1.06–1.61, p = 0.01) were associated with distal disease. CONCLUSION: Female sex, particularly in the context of smoking, is associated with clinically relevant, proximal atherosclerosis expression. Our additional findings that distal atherosclerosis expression is associated with DM, CKD, and older age suggest that PAD has at least two distinct atherosclerotic phenotypes with sex-specific and individual susceptibility to atherogenic risk factors.
format Online
Article
Text
id pubmed-10333498
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-103334982023-07-12 Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease Baretella, Oliver Buser, Laura Andres, Claudine Häberli, Dario Lenz, Armando Döring, Yvonne Baumgartner, Iris Schindewolf, Marc Front Cardiovasc Med Cardiovascular Medicine OBJECTIVE: Atherosclerosis expression varies across not only coronary, cerebrovascular, and peripheral arteries but also within the peripheral vascular tree. The underlying pathomechanisms of distinct atherosclerosis phenotypes in lower extremity peripheral artery disease (PAD) is poorly understood. We investigated the association of cardiovascular risk factors (CVRFs) and atherosclerosis distribution in a targeted approach analyzing symptomatic patients with isolated anatomic phenotypes of PAD. METHODS: In a cross-sectional analysis of consecutive patients undergoing first-time endovascular recanalization for symptomatic PAD, data of patients with isolated anatomic phenotypes of either proximal (iliac) or distal (infrageniculate) atherosclerosis segregation were extracted. We performed a multivariable logistic regression model with backward elimination to investigate the association of proximal and distal PAD with CVRFs. RESULTS: Of the 637 patients (29% females) with endovascular recanalization, 351 (55%) had proximal and 286 (45%) had distal atherosclerosis. Female sex [odds ratio (OR) 0.33, 95% confidence interval (CI) 0.20–0.54, p = 0.01], active smoking (OR 0.16, 95% CI 0.09–0.28, p < 0.001), and former smoking (OR 0.33, 95% CI 0.20–0.57, p < 0.001) were associated with proximal disease. Diabetes mellitus (DM) (OR 3.25, 95% CI 1.93–5.46, p < 0.001), chronic kidney disease (CKD) (OR 1.18, 95% CI 1.08–1.28, p < 0.001), and older age (OR 1.31, 95% CI 1.06–1.61, p = 0.01) were associated with distal disease. CONCLUSION: Female sex, particularly in the context of smoking, is associated with clinically relevant, proximal atherosclerosis expression. Our additional findings that distal atherosclerosis expression is associated with DM, CKD, and older age suggest that PAD has at least two distinct atherosclerotic phenotypes with sex-specific and individual susceptibility to atherogenic risk factors. Frontiers Media S.A. 2023-06-27 /pmc/articles/PMC10333498/ /pubmed/37441701 http://dx.doi.org/10.3389/fcvm.2023.1004003 Text en © 2023 Baretella, Buser, Andres, Häberli, Lenz, Döring, Baumgartner and Schindewolf. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Baretella, Oliver
Buser, Laura
Andres, Claudine
Häberli, Dario
Lenz, Armando
Döring, Yvonne
Baumgartner, Iris
Schindewolf, Marc
Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
title Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
title_full Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
title_fullStr Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
title_full_unstemmed Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
title_short Association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
title_sort association of sex and cardiovascular risk factors with atherosclerosis distribution pattern in lower extremity peripheral artery disease
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10333498/
https://www.ncbi.nlm.nih.gov/pubmed/37441701
http://dx.doi.org/10.3389/fcvm.2023.1004003
work_keys_str_mv AT baretellaoliver associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT buserlaura associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT andresclaudine associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT haberlidario associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT lenzarmando associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT doringyvonne associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT baumgartneriris associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease
AT schindewolfmarc associationofsexandcardiovascularriskfactorswithatherosclerosisdistributionpatterninlowerextremityperipheralarterydisease