Interní Med. 2017; 19(4): 179-185 | DOI: 10.36290/int.2017.032

Why are patients with peripheral artery disease dying unnecessarily for ischemic heart disease?

doc. MUDr. Jan Piťha, CSc.

Interní klinika, FN Motol, Praha

Laboratoř pro výzkum aterosklerózy, Centrum experimentální medicíny,

Institut klinické a experimentální medicíny, Praha

Peripheral artery disease (PAD) is caused mostly by atherosclerotic process similarly as to ischemic heart disease (IHD). Since theatherosclerotic process is diffuse, not surprisingly, other arterial blood vessels are frequently affected. The fate of patients with PADis to be changed by intervention atherosclerosis everywhere in all locations but mainly in coronary arteries. When PAD is diagnosed,it is necessary to immediately get under control four basic risk factors – smoking, diabetes mellitus, dyslipidemia and hypertension– as much as possible and as soon as possible to prevent often fatal manifestation of IHD. The main goal of PAD treatmentis, therefore, not only to relieve claudications and/or to prevent trophic changes in lower limbs, but to minimize the overall risk ofserious cardiovascular events. The cornerstone of this approach are lifestyle measurements – abstinence from smoking, adequatephysical activity and appropriate nutrition. In almost all cases in patients at such high risk, statin therapy should be implemented,and potentiated with ezetimibe; in selected patients with PAD fenofibrate could be considered. Another important steps are thecontrol of hypertension and diabetes mellitus. New treatment modalities including inhibitors of proprotein convertase subtilisinkexin 9, LDL apheresis, rheoferesis can be also important to improve status for high-risk patients.

Keywords: peripheral artery disease, ischemic heart disease, risk factor, management

Published: November 1, 2017  Show citation