Medical therapy for cardiovascular and limb-related risk reduction in critical limb ischemia.
Stefanos GiannopoulosEhrin J ArmstrongPublished in: Vascular medicine (London, England) (2021)
Critical limb ischemia (CLI) constitutes the most advanced form of peripheral artery disease (PAD) and is characterized by ischemic rest pain, tissue loss and/or gangrene. Optimized medical care and risk factor modification in addition to revascularization could reduce the incidence of cardiovascular events and major adverse limb events, improving patients' quality of life and promising higher survival rates. Adequate adherence to cardioprotective medications, including antithrombotic therapy (e.g., antiplatelets, anticoagulants), cholesterol-lowering agents (e.g., statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors), angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), and smoking cessation should be strongly encouraged for patients with CLI. This review examines these guideline-recommended therapies in terms of cardiovascular and limb-related risk reduction in patients with CLI.
Keyphrases
- angiotensin converting enzyme
- angiotensin ii
- cardiovascular events
- smoking cessation
- low density lipoprotein
- risk factors
- peripheral artery disease
- cardiovascular disease
- end stage renal disease
- coronary artery disease
- newly diagnosed
- chronic kidney disease
- replacement therapy
- ejection fraction
- chronic pain
- healthcare
- prognostic factors
- type diabetes
- neuropathic pain
- stem cells
- pain management
- coronary artery bypass grafting
- atrial fibrillation
- bone marrow
- peritoneal dialysis
- skeletal muscle
- acute coronary syndrome
- adipose tissue
- brain injury
- spinal cord injury
- insulin resistance
- glycemic control
- blood brain barrier
- weight loss
- oxidative stress
- binding protein