Particularities of traditional and novel atherosclerotic risk factors in women with peripheral arterial disease in a Romanian Rehabilitation Hospital

• Main Authors: Dan-Horațiu Comşa, Dumitru Zdrenghea, Ioana Berindan-Neagoe, Livia Budişan, Gabriel Guşetu, Adela V. Sitar-Tăuț, Bogdan Caloian, Dana Pop
• Format: Article
• Language: English
• Published: Romanian Association of Balneology, Editura Balneara 2018-12-01
• Series: Balneo Research Journal
• Subjects: : peripheral artery disease; markers; inflammation; women
• Online Access: http://bioclima.ro/Balneo229.pdf
• ISSN: 2069-7597; 2069-7619

Introduction. The increasing prevalence of peripheral arterial disease (PAD) among women is becoming a general healthcare issue, as this populational group is still underrepresented in clinical trials and registries addressing this disease. The aim of this research is to determine women peculiarities in both classical and novel atherosclerosis risk factors in patients admitted in a Romanian Rehabilitation Hospital. Material and methods. 83 consecutive female patients with a mean age of 68.48±10.39 years, symptomatic PAD and a pathological ankle-brachial index were included in the analysis. Data regarding the traditional and novel cardiovascular risk factors, both clinical, biological and paraclinical parameters were all registered. A subgroup of 40 subjects had novel inflammatory markers (hs-CRP, IL-6 and TNF-α) measured, which were compared in a case-control manner to those of 17 agematched healthy controls. Results. Traditional risk factors most prevalent in our overall cohort were hypertension (85%), smoking (44.57%) and diabetes mellitus (45.7%). Mean ankle-brachial index was 0.47±0.17. Novel inflammatory markers were significantly higher in women with symptomatic PAD compared to healthy controls: hs-CRP (p<0.0001), IL-6 (p=0.0053 and TNF-α (p=0.005). Multivariate statistical analysis found ankle-brachial index (ABI)- (p<0.0001), diastolic blood pressure (p=0.0272), obesity (p=0.0445), LDL-cholesterol (p=0.0018), HDL-cholesterol (p=0.0092) and serum creatinine (p<0.0001) to be independent predictors for a more advanced PAD. 59% of the patients exhibited critical limb ischemia on admission, while 60.24% had at least one major arterial occlusion on angiography. Percutaneous revascularization was the most employed treatment method, with 42% of subjects receiving PTA compared to 21.7% in the surgical arm. Conclusion. Women with PAD have specific clinical and biological characteristics that ultimately affect treatment modality, prescription of a rehabilitation program and outcome.