Vascular Medicine最新文献

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High prevalence of breast arterial calcification in pseudoxanthoma elasticum (PXE) - A nationwide study in the Netherlands. 假黄瘤(PXE)中乳房动脉钙化的高发率--荷兰的一项全国性研究。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-08-21 DOI: 10.1177/1358863X241268872
Iris M Harmsen, Madeleine Kok, Frank L Visseren, Wilko Spiering, Pim A de Jong
{"title":"High prevalence of breast arterial calcification in pseudoxanthoma elasticum (PXE) - A nationwide study in the Netherlands.","authors":"Iris M Harmsen, Madeleine Kok, Frank L Visseren, Wilko Spiering, Pim A de Jong","doi":"10.1177/1358863X241268872","DOIUrl":"10.1177/1358863X241268872","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"716-717"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The ankle-brachial index, gastrocnemius mitochondrial respirometry, and walking performance in people with and without peripheral artery disease. 外周动脉疾病患者和非外周动脉疾病患者的踝肱指数、腓肠肌线粒体呼吸测定和行走能力。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-09-06 DOI: 10.1177/1358863X241268893
Mary M McDermott, Sudarshan Dayanidhi, Christiaan Leeuwenburgh, Stephanie E Wohlgemuth, Luigi Ferrucci, Charlotte A Peterson, Lu Tian, Robert Sufit, Lihui Zhao, Joshua Slysz, Tamar S Polonsky, Jack M Guralnik, Melina R Kibbe, Karen J Ho, Michael H Criqui, Dongxue Zhang, Shujun Xu, Philip Greenland
{"title":"The ankle-brachial index, gastrocnemius mitochondrial respirometry, and walking performance in people with and without peripheral artery disease.","authors":"Mary M McDermott, Sudarshan Dayanidhi, Christiaan Leeuwenburgh, Stephanie E Wohlgemuth, Luigi Ferrucci, Charlotte A Peterson, Lu Tian, Robert Sufit, Lihui Zhao, Joshua Slysz, Tamar S Polonsky, Jack M Guralnik, Melina R Kibbe, Karen J Ho, Michael H Criqui, Dongxue Zhang, Shujun Xu, Philip Greenland","doi":"10.1177/1358863X241268893","DOIUrl":"10.1177/1358863X241268893","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial abnormalities exist in lower-extremity peripheral artery disease (PAD), yet the association of the ankle-brachial index (ABI) with mitochondrial respiration in gastrocnemius muscle is unknown. The association of gastrocnemius mitochondrial respiration with 6-minute walk distance in PAD is unknown. This objective of this study was to describe associations of the ABI with mitochondrial respiratory function in gastrocnemius muscle biopsies and associations of gastrocnemius mitochondrial respirometry with 6-minute walk distance in people with and without PAD.</p><p><strong>Methods: </strong>People with (ABI ⩽ 0.90) and without (ABI 1.00-1.40) PAD were enrolled. ABI and 6-minute walk distance were measured. Mitochondrial function of permeabilized myofibers from gastrocnemius biopsies was measured with high-resolution respirometry.</p><p><strong>Results: </strong>A total of 30 people with PAD (71.7 years, mean ABI: 0.64) and 68 without PAD (71.8 years, ABI: 1.17) participated. In non-PAD participants, higher ABI values were associated significantly with better mitochondrial respiration (Pearson correlation for maximal oxidative phosphorylation P<sub>CI+II</sub>: +0.29, <i>p</i> = 0.016). In PAD, the ABI correlated negatively and not significantly with mitochondrial respiration (Pearson correlation for P<sub>CI+II</sub>: -0.17, <i>p</i> = 0.38). In people without PAD, better mitochondrial respiration was associated with better 6-minute walk distance (Pearson correlation: +0.51, <i>p</i> < 0.001), but this association was not present in PAD (Pearson correlation: +0.10, <i>p</i> = 0.59).</p><p><strong>Conclusions: </strong>Major differences exist between people with and without PAD in the association of gastrocnemius mitochondrial respiration with ABI and 6-minute walk distance. Among people without PAD, ABI and walking performance were positively associated with mitochondrial respiratory function. These associations were not observed in PAD.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"640-652"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of collateral circulation in patients with internal carotid artery occlusion: A clinical and ultrasonographic multicenter study. 颈内动脉闭塞患者侧支循环评估:一项临床和超声多中心研究。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-09-08 DOI: 10.1177/1358863X241264759
Ran Liu, Mingjie Gao, Xinyu Zhao
{"title":"Evaluation of collateral circulation in patients with internal carotid artery occlusion: A clinical and ultrasonographic multicenter study.","authors":"Ran Liu, Mingjie Gao, Xinyu Zhao","doi":"10.1177/1358863X241264759","DOIUrl":"10.1177/1358863X241264759","url":null,"abstract":"<p><strong>Background: </strong>Internal carotid artery (ICA) occlusion is the major cause of ischemic stroke. The effect of collateral vessels on cerebral hemodynamics in ICA occlusion remains unclear. This study investigated the correlation between collateral vessels and the peak systolic velocity of the middle cerebral artery (MCA) in patients with ICA occlusion.</p><p><strong>Methods: </strong>The relevant collateral vessels included the anterior communicating (ACoA), posterior communicating (PCoA), and internal-external carotid (IECCA) arteries, respectively. Patients with unilateral ICA occlusion (<i>n</i> = 251) underwent transcranial Doppler imaging to detect the peak systolic velocity (PSV) of the MCA and other intracranial arteries. The clinical symptoms were assessed using the National Institutes of Health Stroke Scale (NIHSS).</p><p><strong>Results: </strong>Patients with ACoA collaterals had significantly higher PSV<sub>MCA</sub> scores and significantly lower NIHSS scores than those without ACoA collaterals (<i>p</i> < 0.001). Patients without any notable collaterals and those with only IECCA had the lowest PSV<sub>MCA</sub> and highest NIHSS scores. The PSV<sub>MCA</sub> and NIHSS scores were negatively correlated (<i>r</i> = -0.566, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Collateral circulation patency in unilateral ICA occlusion was closely associated with clinical symptoms, and patients with ACoA collaterals may have favorable outcomes. <b>(ClinicalTrials.gov Identifier: NCT02397655)</b>.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"707-715"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA). 多族裔动脉粥样硬化研究》(MESA)中经常吸食大麻与颈动脉钙化的关系。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-10-23 DOI: 10.1177/1358863X241287690
Jamie Corroon, Ryan Bradley, Igor Grant, Michael R Daniels, Julie Denenberg, Michael P Bancks, Matthew A Allison
{"title":"Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA).","authors":"Jamie Corroon, Ryan Bradley, Igor Grant, Michael R Daniels, Julie Denenberg, Michael P Bancks, Matthew A Allison","doi":"10.1177/1358863X241287690","DOIUrl":"10.1177/1358863X241287690","url":null,"abstract":"<p><strong>Background: </strong>Studies on cannabis use and adverse cardiovascular outcomes have reported conflicting results. Research on its relationship to calcified arterial plaque remains limited.</p><p><strong>Methods: </strong>Cross-sectional data from 2152 participants at Exam 6 (2016-2018) in the Multi-Ethnic Study of Atherosclerosis (MESA) were analyzed, including self-reported cannabis smoking patterns and carotid artery calcification (CAC) as measured via computed tomography. Multivariable relative and absolute risk regression models were used to estimate adjusted prevalence ratios (PRs) and prevalence differences, respectively, for the presence of calcified plaque. Multivariable linear regression was then used to compare group differences in the extent of CAC in those with calcified plaque.</p><p><strong>Results: </strong>A minority of participants (<i>n</i> = 159, 7.4%) reported a history of regular cannabis smoking. Among all participants, 36.1% (<i>n</i> = 777) had detectable CAC. In models adjusted for demographics, behavioral, and clinical cardiovascular disease factors, a history of regular cannabis smoking was not associated with the prevalence of CAC in either common carotid artery (PR: 1.14, 95% CI: 0.88 to 1.49). In the subset of participants with calcified plaque, and in separate fully adjusted multivariable linear regression models, a history of regular cannabis smoking was not associated with increased calcium volume (difference = 7.7%, 95% CI: -21.8 to 48.5), calcium density (difference = 0.4%, 95% CI: -6.6 to 7.9), or Agatston score (difference = 32.1%, 95% CI: -31.8 to 155.8) in either carotid artery. Models exploring potential effect modification by age, race/ethnicity, and tobacco smoking status showed no significant association, except for higher CAC prevalence in men with a history of regular cannabis smoking.</p><p><strong>Conclusions: </strong>In a racially and ethnically diverse cohort of older adults with a moderately high prevalence of CAC, no associations were found between a history of regular cannabis smoking, duration, or recency of cannabis smoking, and the prevalence of carotid calcified plaque. These findings were consistent across age, race/ethnicity, and cigarette smoking, except for an increased prevalence in men with a history of regular cannabis smoking. Similarly, in a subgroup with CAC, no association was found between a history of regular cannabis smoking and extent of calcification as measured by volume, density, and Agatston score.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"621-631"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
2023-24 Reviewer and Guest Editor Acknowledgements.
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-10-14 DOI: 10.1177/1358863X241291659
{"title":"2023-24 Reviewer and Guest Editor Acknowledgements.","authors":"","doi":"10.1177/1358863X241291659","DOIUrl":"https://doi.org/10.1177/1358863X241291659","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":"29 6","pages":"748-750"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of health status and hospitalization risk for peripheral artery disease in the PORTRAIT registry. PORTRAIT 登记中健康状况与外周动脉疾病住院风险的关联。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-09-25 DOI: 10.1177/1358863X241274758
Jacob Cleman, Gaëlle Romain, Lindsey E Scierka, Clementine Labrosciano, Brooklyn Bradley, Robert Fitridge, John Beltrame, Mehdi H Shishehbor, John A Spertus, Carlos Mena-Hurtado, Kim G Smolderen
{"title":"Association of health status and hospitalization risk for peripheral artery disease in the PORTRAIT registry.","authors":"Jacob Cleman, Gaëlle Romain, Lindsey E Scierka, Clementine Labrosciano, Brooklyn Bradley, Robert Fitridge, John Beltrame, Mehdi H Shishehbor, John A Spertus, Carlos Mena-Hurtado, Kim G Smolderen","doi":"10.1177/1358863X241274758","DOIUrl":"10.1177/1358863X241274758","url":null,"abstract":"<p><strong>Background: </strong>Healthcare utilization for patients with peripheral artery disease (PAD) is high, but stratifying patients' risk of hospitalization at initial evaluation is challenging. We examined the association between health status at PAD presentation and risk of (1) combined all-cause hospital admissions and emergency department (ED) visits and (2) all-cause hospital admissions.</p><p><strong>Methods: </strong>Patients with claudication enrolled at US sites in the PORTRAIT registry were included. Health status was assessed using the Peripheral Artery Questionnaire (PAQ), a PAD-specific patient-reported outcome measure. Crude overall and cause-specific hospital admissions and ED visits were reported by PAQ overall summary score (PAQ-OS) ranges (0-24, 25-49, 50-74, and 75-100). Kaplan-Meier survival and unadjusted and adjusted Cox proportional hazards models examined the association between baseline PAQ scores and (1) combined all-cause hospital admissions or ED visits and (2) all-cause hospital admissions over 12 months.</p><p><strong>Results: </strong>Of 796 patients, 349 (44%) had a hospital admission or ED visit over 12 months. Patients in the lowest (PAQ-OS = 0-24) versus the highest range (PAQ-OS = 75-100) had higher rates of 12-month (53.3% vs 22.4%) hospital admission and ED visits. In the adjusted model, each 10-point decrease in PAQ-OS was associated with a higher risk of all-cause hospital admission and ED visits (HR = 1.1, 95% CI 1.1-1.2, <i>p</i> < 0.0010) and all-cause hospital admission (HR = 1.1, 95% CI 1.1-1.2, <i>p</i> < 0.0010) at 12 months.</p><p><strong>Conclusion: </strong>PAD-specific health status is associated with an increased risk of healthcare utilization. Baseline health status may help stratify risk in patients with PAD, although replication and further validation of results are necessary.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"664-674"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with sustained improvement after peripheral vascular intervention in patients with claudication. 跛行患者外周血管介入治疗后病情持续改善的相关因素。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-08-01 DOI: 10.1177/1358863X241261369
Poghni A Peri-Okonny, Gaëlle Romain, Vikash Rambhujun, Santiago Callegari, Aseem Vashist, Jacob Cleman, Kim G Smolderen, Carlos Mena-Hurtado
{"title":"Factors associated with sustained improvement after peripheral vascular intervention in patients with claudication.","authors":"Poghni A Peri-Okonny, Gaëlle Romain, Vikash Rambhujun, Santiago Callegari, Aseem Vashist, Jacob Cleman, Kim G Smolderen, Carlos Mena-Hurtado","doi":"10.1177/1358863X241261369","DOIUrl":"10.1177/1358863X241261369","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"718-719"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantifying patients' preferences on tradeoffs between mortality risk and reduced need for target vessel revascularization for claudication. 量化患者对死亡风险与减少跛行靶血管再通术需求之间权衡的偏好。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-10-16 DOI: 10.1177/1358863X241290233
Shelby D Reed, Jessie Sutphin, Matthew J Wallace, Juan Marcos Gonzalez, Jui-Chen Yang, F Reed Johnson, Jennifer Tsapatsaris, Michelle E Tarver, Anindita Saha, Allen L Chen, David J Gebben, Misti Malone, Andrew Farb, Olufemi Babalola, Eva M Rorer, Sahil A Parikh, Jessica P Simons, W Schuyler Jones, Mitchell W Krucoff, Eric A Secemsky, Matthew A Corriere
{"title":"Quantifying patients' preferences on tradeoffs between mortality risk and reduced need for target vessel revascularization for claudication.","authors":"Shelby D Reed, Jessie Sutphin, Matthew J Wallace, Juan Marcos Gonzalez, Jui-Chen Yang, F Reed Johnson, Jennifer Tsapatsaris, Michelle E Tarver, Anindita Saha, Allen L Chen, David J Gebben, Misti Malone, Andrew Farb, Olufemi Babalola, Eva M Rorer, Sahil A Parikh, Jessica P Simons, W Schuyler Jones, Mitchell W Krucoff, Eric A Secemsky, Matthew A Corriere","doi":"10.1177/1358863X241290233","DOIUrl":"10.1177/1358863X241290233","url":null,"abstract":"<p><strong>Background: </strong>In 2019, the US Food and Drug Administration issued a warning that symptomatic relief from claudication using paclitaxel-coated devices might be associated with an increase in mortality over 5 years. We designed a discrete-choice experiment (DCE) to quantify tradeoffs that patients would accept between a decreased risk of clinically driven target-vessel revascularization (CDTVR) and increased mortality risk.</p><p><strong>Methods: </strong>Patients with claudication symptoms were recruited from seven medical centers to complete a web-based survey including eight DCE questions that presented pairs of hypothetical device profiles defined by varying risks of CDTVR and overall mortality at 2 and 5 years. Random-parameters logit models were used to estimate relative preference weights, from which the maximum-acceptable increase in 5-year mortality risk was derived.</p><p><strong>Results: </strong>A total of 272 patients completed the survey. On average, patients would accept a device offering reductions in CDTVR risks from 30% to 10% at 2 years and from 40% to 30% at 5 years if the 5-year mortality risk was less than 12.6% (95% CI: 11.8-13.4%), representing a cut-point of 4.6 percentage points above a baseline risk of 8%. However, approximately 40% chose the device alternative with the lower 5-year mortality risk in seven (20.6%) or eight (18.0%) of the eight DCE questions regardless of the benefit offered.</p><p><strong>Conclusions: </strong>Most patients in the study would accept some incremental increase in 5-year mortality risk to reduce the 2-year and 5-year risks of CDTVR by 20 and 10 percentage points, respectively. However, significant patient-level variability in risk tolerance underscores the need for systematic approaches to support benefit-risk decision making.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"675-683"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining patient goals for therapy in peripheral artery disease: A need for collaborative science. 确定外周动脉疾病患者的治疗目标:需要合作科学。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1177/1358863X241295728
Shea E Hogan, Megan Coylewright
{"title":"Defining patient goals for therapy in peripheral artery disease: A need for collaborative science.","authors":"Shea E Hogan, Megan Coylewright","doi":"10.1177/1358863X241295728","DOIUrl":"10.1177/1358863X241295728","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"684-686"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries. 老年人肺栓塞治疗策略的性别差异:针对 RIETE 参与者和美国医疗保险受益人的 SERIOUS-PE 研究。
IF 3 3区 医学
Vascular Medicine Pub Date : 2024-11-26 DOI: 10.1177/1358863X241292023
Behnood Bikdeli, Hannah Leyva, Alfonso Muriel, Zhenqiu Lin, Gregory Piazza, Candrika D Khairani, Rachel P Rosovsky, Ghazaleh Mehdipour, Michelle L O'Donoghue, Olga Madridano, Juan Bosco Lopez-Saez, Meritxell Mellado, Ana Maria Diaz Brasero, Elvira Grandone, Primavera A Spagnolo, Yuan Lu, Laurent Bertoletti, Luciano López-Jiménez, Manuel Jesús Núñez, Ángeles Blanco-Molina, Marie Gerhard-Herman, Samuel Z Goldhaber, Shannon M Bates, David Jimenez, Harlan M Krumholz, Manuel Monreal
{"title":"Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries.","authors":"Behnood Bikdeli, Hannah Leyva, Alfonso Muriel, Zhenqiu Lin, Gregory Piazza, Candrika D Khairani, Rachel P Rosovsky, Ghazaleh Mehdipour, Michelle L O'Donoghue, Olga Madridano, Juan Bosco Lopez-Saez, Meritxell Mellado, Ana Maria Diaz Brasero, Elvira Grandone, Primavera A Spagnolo, Yuan Lu, Laurent Bertoletti, Luciano López-Jiménez, Manuel Jesús Núñez, Ángeles Blanco-Molina, Marie Gerhard-Herman, Samuel Z Goldhaber, Shannon M Bates, David Jimenez, Harlan M Krumholz, Manuel Monreal","doi":"10.1177/1358863X241292023","DOIUrl":"https://doi.org/10.1177/1358863X241292023","url":null,"abstract":"<p><strong>Introduction: </strong>Sex differences exist in risk factors and comorbidities of older adults (aged ⩾ 65 years) with pulmonary embolism (PE). Clinically relevant sex-based treatment disparities for PE have not been adequately addressed. The few existing show conflicting results due to small sample size (type II error) and suboptimal methods (overreliance on <i>p</i>-value, which may detect differences of small clinical relevance).</p><p><strong>Methods: </strong>We assessed sex differences in anticoagulation and advanced therapies for PE in older adults, utilizing data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a large PE registry with predominant participation from Europe, and data from US Medicare beneficiaries. We prespecified a standardized difference (SRD) > 10% as clinically relevant. RIETE included 33,462 (57.7% female) and Medicare included 102,391 (55.0% female) older adults with PE.</p><p><strong>Results: </strong>In RIETE, there were no overall sex differences in the use of anticoagulation (median: 181 vs 180 days, SRD < 1%), fibrinolysis (SRD < 3%), thrombectomy (SRD < 2%), or inferior vena cava (IVC) filters (SRD: 4.4%). However, fibrinolytic therapy (systemic or catheter-based) was less often used in female than male patients with intermediate-risk PE (8.0% vs 12.1%, SRD: 13.6%). No sex differences were noted with advanced PE therapies in Medicare beneficiaries. In unadjusted analyses, fibrinolysis and IVC filter placement were more frequent in Medicare than RIETE participants regardless of sex (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In a predominantly European PE registry and a US study of older adults, there were no overall sex differences in anticoagulation patterns or advanced therapy utilization. Future studies should determine if sex disparities in fibrinolytic therapy for intermediate-risk PE and greater use of advanced therapies in US older adults correlate with clinical outcomes.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241292023"},"PeriodicalIF":3.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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