Premature atherosclerotic peripheral artery disease: An underrecognized and undertreated disorder with a rising global prevalence |
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| Authors: | Anurag Mehta Devinder S Dhindsa Ananya Hooda Aditi Nayak Chris S Massad Birju Rao Leyla Fowe Makue Ravi R Rajani Olamide Alabi Arshed A Quyyumi Guillermo A Escobar Bryan J Wells Laurence S Sperling |
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| Institution: | 1. Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia;2. Department of Medicine, Emory University School of Medicine, Atlanta, Georgia;3. Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia;1. Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Vrije Universiteit Brussel, Belgium;2. Cardiac Surgery Department, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium;1. Department of Cardiothoracic Surgery, Stanford University School of Medicine, 300 Pasteur Dr, Suite 1347, Stanford, CA 94305-5515, USA;2. Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA;1. Barts Heart Centre, St Bartholomew''s Hospital, London, UK;2. Department of Cardiology, Ain Shams University, Cairo, Egypt;1. The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Section 2142, Blegdamsvej 9, 2100 Copenhagen, Denmark;2. Department of Medicine and Surgery, University of Copenhagen, Copenhagen, Denmark;1. Department of Histology and Embryology, Collegium Anatomicum, Medical University of Warsaw, Poland;2. Department of Pathology, Medical University of Warsaw, Collegium Anatomicum, Poland;3. Department of Pathology, Children''s Memorial Health Institute, Warsaw, Poland;4. Department of Immunology, Medical University of Warsaw, Poland;5. The Doctoral School of the Medical University of Warsaw, Poland;6. Department of Clinical Anatomy, Collegium Anatomicum, Medical University of Warsaw, Poland;7. Inserm U1096, Rouen Institute for Research and Innovation in Biomedicine, Medical Faculty of Rouen University, 22 Boulevard Gambetta, 76183 Rouen, France |
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| Abstract: | Premature atherosclerotic peripheral artery disease (PAD) of the lower extremities is characterized by disease diagnosis before the age of 50 years. The global prevalence of premature PAD has increased, and the disease is often underdiagnosed given heterogenous patient symptoms. Traditional cardiovascular risk factors like smoking, diabetes, hypertension, and hyperlipidemia as well as non-traditional risk factors like elevated lipoprotein(a), family history of PAD, hypercoagulability, and systemic inflammation are associated with premature PAD. Patients with premature PAD tend to have an aggressive vascular disease process, a high burden of cardiovascular risk factors, and other concomitant atherosclerotic vascular diseases like coronary artery disease. Prevention of cardiovascular events, improvement of symptoms and functional status, and prevention of adverse limb events are the main goals of patient management. In this review, we discuss the epidemiology, risk factors, clinical evaluation, and management of patients with premature PAD. |
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