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Smoking, Lipids and Diabetes Have Different Impact on PAD

Smoking cessation is best way to slow progression of peripheral arterial disease

TUESDAY, May 30 (HealthDay News) -- While smoking, lipids and inflammation are known to contribute to the progression of large-vessel (LV) peripheral arterial disease (PAD), only diabetes significantly predicts small-vessel (SV) PAD, according to a study published online May 30 in Circulation: Journal of the American Heart Association.

Victor Aboyans, M.D., Ph.D., of the University of California San Diego, and colleagues followed up on 403 patients with baseline data on vascular condition to assess the progression of both SV-PAD and LV-PAD. Those with the highest decile of progression of LV-PAD had a -0.30 ankle brachial index decrease. For SV-PAD, the definition was a -0.27 toe brachial index decrease.

The study looked at traditional risk factors for PAD, as well as the roles of high-sensitivity C-reactive protein, serum amyloid-A, lipoprotein(a) and homocysteine. The patients were followed up for an average of 4.6 years.

The main factors related to progression of LV-PAD progression were current smoking, ratio of total cholesterol to high-density lipoprotein cholesterol, lipoprotein(a) and high-sensitivity C-reactive protein. Diabetes was the only factor associated with SV-PASD progression.

"Smoking cessation is the most efficient way to slow the progression of PAD, along with altering cholesterol levels through diet, exercise and medication," Aboyans said in a statement. "By highlighting and focusing preventive efforts on the risk factors, we can improve the prognosis."

One researcher is co-inventor of a patent relating to the use of inflammatory biomarkers in cardiovascular disease.

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