| Impact of long-term corticosteroid therapy on the distribution pattern of lower limb atherosclerosis. | |
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MedLine Citation:
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PMID: 20172747 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Ectopic calcification and mediacalcinosis can be promoted by corticosteroid use. Aim of the present investigation is to describe macrovascular disease features in patients with long-term corticosteroid therapy and symptomatic lower limb peripheral arterial occlusive disease (PAD). METHODS: A consecutive series of 2783 patients undergoing clinical and angiographic work-up of PAD were screened for long-term (>5 years) corticosteroid use (group A). Comparison was performed to a randomly selected age-, sex- and risk factor-matched PAD control cohort from the same series without corticosteroid use (group B). Patients with diabetes mellitus or severe renal failure were excluded. Arterial calcification was evaluated by qualitative assessment on radiographic images. Severity of atherosclerotic lesions was analysed from angiographic images using a semi-quantitative score (Bollinger score). RESULTS: In general, 12 patients (5 males, mean age 78.5 +/- 9.0 years) with 15 ischaemic limbs qualified to be enrolled in group A and were compared to 23 matching control patients (6 2 males, mean age 79.5 +/- 6 years) with 32 ischaemic limbs. Incompressibility of ankle arteries determined by measurement of the ankle-brachial index was seen in 12 limbs (80%) in group A compared to 3 limbs (9%) in group B (p = 0.0009). No significant difference was found comparing group A and B for segmental calcification, whereas comparison of the atherosclerotic burden using the angiographic severity score showed a significantly higher score at the infragenicular arterial level in group A (p = 0.001). CONCLUSION: Findings suggest that the long-term corticosteroid therapy is associated with a distally accentuated, calcifying peripheral atherosclerosis inducing arterial incompressibility. This occlusion pattern is comparable to patients with renal failure or diabetes. Further research is required to support our observations. |
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Authors:
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T Willenberg; N Diehm; M Zwahlen; C Kalka; D-D Do; S Gretener; J Ortmann; I Baumgartner |
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Publication Detail:
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Type: Journal Article Date: 2010-02-20 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 39 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-05 Completed Date: 2010-04-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 441-6 Citation Subset: IM |
Affiliation:
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Swiss Cardiovascular Center, Division of Clinical and Interventional Angiology, Inselspital, University of Bern, Bern, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Cortex Hormones
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administration & dosage,
adverse effects* Aged Aged, 80 and over Ankle / blood supply Atherosclerosis / chemically induced*, physiopathology, radiography Blood Pressure Brachial Artery / physiopathology Calcinosis / chemically induced*, physiopathology, radiography Case-Control Studies Compliance Drug Administration Schedule Female Humans Ischemia / chemically induced*, physiopathology, radiography Lower Extremity / blood supply* Male Prospective Studies Risk Assessment Risk Factors Severity of Illness Index Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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