Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association.
Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association.
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DOI：
10.1161/cir.0000000000001005
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发表时间：
2021-08-31
期刊：
影响因子：
37.8
通讯作者：
Ujueta, Francisco
中科院分区：
文献类型：
--
作者：
Criqui, Michael H.;Matsushita, Kunihiro;Aboyans, Victor;Hess, Connie N.;Hicks, Caitlin W.;Kwan, Tak W.;McDermott, Mary M.;Misra, Sanjay;Ujueta, Francisco
下肢外周动脉疾病（PAD）影响全球超过2.3亿成年人，并与各种不良临床结局（其他心血管疾病，如冠心病和中风以及腿部结局，如截肢）的风险增加相关。尽管其患病率和临床重要性，PAD一直被卫生保健专业人员和患者低估。这种低估似乎是多因素造成的（例如，临床一线诊断测试踝臂指数的可用性有限;错误地认为腿部血管疾病不是致命的，PAD的诊断不一定会改变临床实践）。在过去几年中，大量证据表明，这些看法是不正确的。一些研究一致表明，许多PAD患者没有接受循证治疗。因此，本科学声明为医疗保健专业人员提供了关于PAD当代流行病学（例如，患病率、时间趋势、风险因素和并发症）、诊断现状（生理检查和成像方式）以及PAD管理中的主要差距（例如，药物治疗、运动疗法和血运重建）的最新信息。该声明还列出了与PAD相关的研究，临床实践和实施方面的主要差距。需要各方（如医疗保健提供者、研究人员、专家组织和医疗保健组织）共同努力，以提高对PAD的认识和理解，并改善PAD的诊断方法、管理和预后。
Lower extremity peripheral artery disease (PAD) affects >230 million adults worldwide and is associated with increased risk of various adverse clinical outcomes (other cardiovascular diseases such as coronary heart disease and stroke and leg outcomes such as amputation). Despite its prevalence and clinical importance, PAD has been historically underappreciated by health care professionals and patients. This underappreciation seems multifactorial (eg, limited availability of the first-line diagnostic test, the ankle-brachial index, in clinics; incorrect perceptions that a leg vascular disease is not fatal and that the diagnosis of PAD would not necessarily change clinical practice). In the past several years, a body of evidence has indicated that these perceptions are incorrect. Several studies have consistently demonstrated that many patients with PAD are not receiving evidence-based therapies. Thus, this scientific statement provides an update for health care professionals regarding contemporary epidemiology (eg, prevalence, temporal trends, risk factors, and complications) of PAD, the present status of diagnosis (physiological tests and imaging modalities), and the major gaps in the management of PAD (eg, medications, exercise therapy, and revascularization). The statement also lists key gaps in research, clinical practice, and implementation related to PAD. Orchestrated efforts among different parties (eg, health care providers, researchers, expert organizations, and health care organizations) will be needed to increase the awareness and understanding of PAD and improve the diagnostic approaches, management, and prognosis of PAD.