×
Home Current Archive Editorial board
News Contact
Review paper

Epidemiology of hospitalized patients with peripheral arterial disease in Bosnia and Herzegovina

By
Akif Mlačo Orcid logo ,
Akif Mlačo
Contact Akif Mlačo

Department of Angiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Nejra Mlačo ,
Nejra Mlačo

Health Centre, Visoko , Visoko , Bosnia and Herzegovina

Mevludin Mekić ,
Mevludin Mekić

Department of Rheumatology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Alen Džubur
Alen Džubur

Department of Cardiology, Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Abstract

Aim
To investigate a profile of patients with peripheral artery disease (PAD) in Bosnia and Herzegovina.
Methods
This observational study included 1022 patients hospitalized at the Clinical Centre University of Sarajevo in a 5-year period, 2015 to 2019.
Results
Disease prevalence rises sharply after the age of 50. Most patients, 797 (78%) had proximal PAD; 658 (64.4%) were
males. The death occurred in 73 (7.1%) patients, more often in females (66- 10%), and in patients with chronic kidney disease (10- 23.8%). Amputation occurred in 153 (15%) patients, where 102 (66.7%) patients had diabetes. Other surgical procedures were more common in males and smokers. Necrosis and phlegmon on lower extremities were found in 563 (55.1%) and 43 (4.2%) patients, respectively. History of tobacco use was noted in 620 (60.2%) patients, and 414 (40.8%) patients were current smokers. More than a half of patients had hypertension and diabetes, 596 (58.3%)
and 513 (50.2%), respectively. One in 10 patients had a history of myocardial infarction or stroke. Most patients had high fibrinogen and blood glucose and low high-density lipoprotein (HDL).
Conclusion
Patients with PAD have multiple comorbidities and risk for various complications. Primary and secondary prevention
of risk factors is the mainstay of treatment.

References

1.
Conte SM, Vale PR. Peripheral arterial disease. Heart Lung Circ. 2018;27:427–32.
2.
Olinic DM, Spinu M, Olinic M, Homorodean C, Tataru DA, Liew A, et al. Epidemiology of peripheral artery disease in Europe: VAS Educational Paper. Int Angiol. 2018;37:327–34.
3.
Fowkes FG, Aboyans V, Fowkes FJ, McDermott MM, Sampson UK, Criqui MH. Peripheral artery disease: epidemiology and global perspectives. Nat Rev Cardiol. 2017;14:156–70.
4.
Firnhaber JM, Powell CS. Lower extremity peripheral artery disease: diagnosis and treatment. Am Fam Physician. 2019;99:362–9.
5.
Tada H, Usui S, Sakata K, Takamura M, Kawashiri MA. Low-density lipoprotein cholesterol level cannot be too low: considerations from clinical trials, human genetics, and biology. J Atheroscler Thromb. 2020;27:489–98.
6.
Allison MA, Ho E, Denenberg JO, Langer RD, Newman AB, Fabsitz RR, et al. Ethnic-specific prevalence of peripheral arterial disease in the United States. Am J Prev Med. 2007;32:328–33.
7.
Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004;110:738–43.
8.
Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly: The Rotterdam Study. Vol. 18. 1998.
9.
Egorova N, Vouyouka AG, Quin J, Guillerme S, Moskowitz A, Marin M, et al. Analysis of genderrelated differences in lower extremity peripheral arterial disease. J Vasc Surg. 2010;51:372–8.
10.
McCoach CE, Armstrong EJ, Singh S, Javed U, Anderson D, Yeo KK, et al. Gender-related variation in the clinical presentation and outcomes of critical limb ischemia. Vasc Med. 2013;18:19–26.
11.
Vouyouka AG, Egorova NN, Salloum A, Kleinman L, Marin M, Faries PL, et al. Lessons learned from the analysis of gender effect on risk factors and procedural outcomes of lower extremity arterial disease. J Vasc Surg. 2010;52:1196–202.
12.
Feinglass J, Kaushik S, Handel D, Kosifas A, Martin GJ, Pearce WH. Peripheral bypass surgery and amputation: northern Illinois demographics. Arch Surg. 1993;135:75–80.
13.
Joosten MM, Pai JK, Bertoia ML, Rimm EB, Spiegelman D, Mittleman MA, et al. Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men. JAMA. 2012;308:1660–7.
14.
Haltmayer M, Mueller T, Horvath W, Luft C, Poelz W, Haidinger D. Impact of atherosclerotic risk factors on the anatomical distribution of peripheral arterial disease. Int Angiol. 2001;20:200–7.
15.
The World Bank Data. Diabetes prevalence (% of population ages 20 to 79) 2019. 2021;
16.
Liew YP, Bartholomew D, S M, J S, M.J. Combined effect of chronic kidney disease and peripheral arterial disease on all-cause mortality in a high-risk population. Clin J Am Soc Nephrol. 2008;3:1084–9.
17.
O’Hare AM, Glidden DV, Fox CS, Hsu CY. High prevalence of peripheral arterial disease in persons with renal insufficiency: results from the National Health and Nutrition Examination Survey 1999-2000. Circulation. 2004;109:320–3.
18.
O’Hare AM, Vittinghoff E, Hsia J, Shlipak MG. Renal insufficiency and the risk of lower extremity peripheral arterial disease: results from the Heart and Estrogen/Progestin Replacement Study (HERS. J Am Soc Nephrol. 2004;15:1046–51.
19.
Pasqualini L, Schillaci G, Pirro M, Vaudo G, Siepi D, Innocente S, et al. Renal dysfunction predicts long-term mortality in patients with lower extremity arterial disease. J Intern Med. 2007;262:668–77.
20.
Lacroix P, Aboyans V, Desormais I, Kowalsky T, Cambou JP, Constans J, et al. Chronic kidney disease and the short-term risk of mortality and amputation in patients hospitalized for peripheral artery disease. J Vasc Surg. 2013;58:966–71.
21.
O’Hare AM, Sidawy AN, Feinglass J, Merine KM, Daley J, Khuri S, et al. Influence of renal insufficiency on limb loss and mortality after initial lower extremity surgical revascularization. J Vasc Surg. 2004;39:709–16.
22.
O’Hare AM, Bertenthal D, Sidawy AN, Shlipak MG, Sen S, Chren MM. Renal insufficiency and use of revascularization among a national cohort of men with advanced lower extremity peripheral arterial disease. Clin J Am Soc Nephrol. 2006;1:297–304.
23.
Landray MJ, Thambyrajah J, McGlynn FJ, Jones HJ, Baigent C, Kendall MJ, et al. Epidemiological evaluation of known and suspected cardiovascular risk factors in chronic renal impairment. Am J Kidney Dis. 2001;38:537–46.
24.
Beckman JA, Paneni F, Cosentino F, Creager MA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part II. Eur Heart J. 2013;34:2444–52.
25.
Abbott RD, Brand FN, Kannel WB. Epidemiology ofsome peripheral arterial findings in diabetic men and women: experiences from the Framingham Study. Am J Med. 1990;88:376–81.
26.
Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral arterial disease in diabetic and nondiabetic patients: a comparison of severity and outcome. Diabetes Care. 2001;24:1433–7.
27.
Murabito JM, Evans JC, Nieto K, Larson MG, Levy D, Wilson PW. Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J. 2002;143:961–5.
28.
Allison MA, Criqui MH, McClelland RL, Scott JM, McDermott MM, Liu K, et al. The effect of novel cardiovascular risk factors on the ethnic-specific odds for peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis (MESA. J Am Coll Cardiol. 2006;48:1190–7.
29.
Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001;285:2481–5.
30.
Beks PJ, Mackaay AJ, Neeling JN, Vries H, Bouter LM, Heine RJ. Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn study. Diabetologia. 1995;38:86–96.
31.
Criqui MH, Browner D, Fronek A, Klauber MR, Coughlin SS, Barrett-Connor E, et al. Peripheral arterial disease in large vessels is epidemiologically distinct from small vessel disease. An analysis of risk factors Am J Epidemiol. 1989;129:1110–9.
32.
Fowkes FG, Housley E, Riemersma RA, Macintyre CC, Cawood EH, Prescott RJ, et al. Smoking, lipids, glucose intolerance, and blood pressure as risk factors for peripheral atherosclerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol. 1992;135:331–40.
33.
Katsilambros NL, Tsapogas PC, Arvanitis MP, Tritos NA, Alexiou ZP, Rigas KL. Risk factors for lower extremity arterial disease in non-insulin-dependent diabetic persons. Diabet Med. 1996;13:243–6.
34.
Bainton D, Sweetnam P, Baker I, Elwood P. Peripheral vascular disease: consequence for survival and association with risk factors in the Speedwell prospective heart disease study. Br Heart J. 1994;72:128–32.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.