2023
Disparities in Diagnosis, Treatment, and Outcomes of Peripheral Artery Disease JACC Scientific Statement
McDermott M, Ho K, Alabi O, Criqui M, Goodney P, Hamburg N, McNeal D, Pollak A, Smolderen K, Bonaca M. Disparities in Diagnosis, Treatment, and Outcomes of Peripheral Artery Disease JACC Scientific Statement. Journal Of The American College Of Cardiology 2023, 82: 2312-2328. PMID: 38057074, DOI: 10.1016/j.jacc.2023.09.830.Peer-Reviewed Original ResearchConceptsPeripheral arterial diseaseRate of amputationAmputation ratePeripheral arterial disease prevalencePrevalence of peripheral arterial diseaseLower extremity peripheral arterial diseasePeripheral arterial disease outcomesHealth policy changesCulturally appropriate messagesHigher amputation rateOptimal medical careHealth carePatient educationDisparity eliminationMobility lossSocioeconomic statusClinician educationMedical careImprove accessLower extremity revascularizationUnited StatesAtypical symptomsOlder ageDisparitiesAmputationRepresentativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines
Castro-Dominguez Y, Mena-Hurtado C, Algara M, Obas V, Ahmed Z, Romain G, Solaru K, Smolderen K. Representativeness of Peripheral Artery Disease Randomized Clinical Trials Supporting Current Guidelines. The American Journal Of Cardiology 2023, 201: 166-169. PMID: 37385170, DOI: 10.1016/j.amjcard.2023.05.053.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiologyEthnicityFemaleHumansLower ExtremityPeripheral Arterial DiseaseRandomized Controlled Trials as TopicUnited StatesConceptsPeripheral artery diseasePAD guidelinesArtery diseaseRecent American Heart Association/American CollegeAmerican Heart Association/American CollegeLower extremity peripheral artery diseaseOlder adult patientsRace/ethnicity distributionAdult patientsPooled proportionMean ageClinical trialsCurrent guidelinesEpidemiologic studiesAmerican CollegeTrial participantsRCTsEthnicity distributionOlder adultsTrialsWomenPatientsDiseaseGuidelinesEthnic groupsComparison of lower extremity bypass and peripheral vascular intervention for chronic limb-threatening ischemia in the Medicare-linked Vascular Quality Initiative
Cleman J, Romain G, Grubman S, Guzman R, Smolderen K, Mena-Hurtado C. Comparison of lower extremity bypass and peripheral vascular intervention for chronic limb-threatening ischemia in the Medicare-linked Vascular Quality Initiative. Journal Of Vascular Surgery 2023, 78: 745-753.e6. PMID: 37207790, PMCID: PMC10964324, DOI: 10.1016/j.jvs.2023.05.015.Peer-Reviewed Original ResearchConceptsChronic limb-threatening ischemiaLower extremity bypassPeripheral vascular interventionsVascular Quality InitiativeLimb-threatening ischemiaCause mortalityRisk of deathExtremity bypassVascular interventionsQuality InitiativeCox proportional hazards regressionKaplan-Meier survival curvesProportional hazards regressionOverall mean ageLogistic regression modelsComparative effectiveness researchKnee poplitealMedicare registryInfrapopliteal arteriesHazards regressionMean ageThirty-dayHispanic ethnicityOutcome dataTreatment groupsLower extremity symptoms and ankle–brachial index screening as predictors of cardiovascular outcomes in Black adults
Lee M, Smolderen K, Ionescu C, Hillegass W, Romain G, Mena-Hurtado C. Lower extremity symptoms and ankle–brachial index screening as predictors of cardiovascular outcomes in Black adults. Vascular Medicine 2023, 28: 197-204. PMID: 37293738, DOI: 10.1177/1358863x231151729.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseAbnormal ABILower extremity symptomsNormal ABILeg symptomsHigh riskBlack adultsExtremity symptomsStepwise Cox proportional hazards modelKaplan-Meier survival curvesCox proportional hazards modelAnkle-brachial indexFramingham risk factorsJackson Heart StudyProportional hazards modelCardiovascular outcomesCause mortalityArtery diseaseAsymptomatic diseaseAdverse outcomesMean ageSymptom assessmentAsymptomatic participantsRisk factorsSymptomatic participants
2022
Variability in Antithrombotic Therapy after Infrainguinal Lower Extremity Bypass
Brahmandam A, Lee M, Bellamkonda K, Provance JB, Sumpio B, Ochoa Chaar CI, Smolderen KG, Mena-Hurtado C, Guzman RJ. Variability in Antithrombotic Therapy after Infrainguinal Lower Extremity Bypass. Annals Of Vascular Surgery 2022, 88: 51-62. PMID: 36245106, DOI: 10.1016/j.avsg.2022.08.016.Peer-Reviewed Original ResearchConceptsInfrainguinal lower extremity bypassLower extremity bypassDual antiplatelet therapySingle antiplatelet therapyAntithrombotic therapyCombination therapyAntiplatelet therapyMedian odds ratioExtremity bypassDistal targetsHierarchical multivariable logistic regressionCenter-level variabilityCommon combination therapyPatient-level factorsPercutaneous coronary interventionPeripheral vascular interventionsMultivariable logistic regressionMultivariable regression modelsAntiplatelet monotherapyBypass targetAntithrombotic regimensPostoperative bleedingTriple therapyCoronary interventionAntithrombotic strategiesRisk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease
Luna P, Harris K, Castro-Dominguez Y, Algara M, Severiche-Mena C, Smolderen KG, Mena-Hurtado C. Risk profiles, access to care, and outcomes in Hispanics hospitalized for lower extremity peripheral artery disease. Journal Of Vascular Surgery 2022, 77: 216-224.e15. PMID: 36037965, DOI: 10.1016/j.jvs.2022.08.021.Peer-Reviewed Original ResearchConceptsPeripheral artery diseaseLower extremity peripheral artery diseaseNon-Hispanic whitesEmergency departmentPAD careArtery diseaseRisk factorsSevere peripheral artery diseaseChronic limb-threatening ischemiaRisk profileNational Inpatient Sample dataCardiovascular risk factorsLimb-threatening ischemiaPatients' sociodemographic characteristicsWorse clinical outcomesMultivariable logistic regressionAssociation of ethnicityLength of stayHealth care consumptionHealth care coveragePAD hospitalizationsPrior amputationEndovascular revascularizationED admissionRenal failureFrailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI)
Al-Damluji MS, Smolderen KG, Meng C, Dai F, Nanna MG, Sumpio B, Henke P, Mena-Hurtado C. Frailty and outcomes following revascularization of lower-extremity peripheral artery disease: Insights from the Vascular Quality Initiative (VQI). Vascular Medicine 2022, 27: 251-257. PMID: 35485400, DOI: 10.1177/1358863x221083701.Peer-Reviewed Original ResearchConceptsRisk Analysis IndexVascular Quality InitiativeLower extremity revascularizationFrailty screening toolsMFI-5Lower extremity peripheral artery diseaseScreening toolFrailty detectionAddition of frailtyPAD risk factorsPeripheral artery diseasePAD populationRevascularization typeVascular cohortMajor amputationPerioperative outcomesArtery diseaseFrailty indexFrailty toolsAdjusted analysisUnplanned amputationRisk factorsHigher oddsPredictive valuePatientsAnkle- and Toe-Brachial Index for Peripheral Artery Disease Identification: Unlocking Clinical Data Through Novel Methods
Friberg JE, Qazi AH, Boyle B, Franciscus C, Vaughan-Sarrazin M, Westerman D, Patterson OV, Parr SK, Matheny ME, Arya S, Smolderen KG, Lund BC, Gobbel GT, Girotra S. Ankle- and Toe-Brachial Index for Peripheral Artery Disease Identification: Unlocking Clinical Data Through Novel Methods. Circulation Cardiovascular Interventions 2022, 15: e011092. PMID: 35176872, PMCID: PMC10807980, DOI: 10.1161/circinterventions.121.011092.Peer-Reviewed Original ResearchMeSH KeywordsAnkleAnkle Brachial IndexHumansLower ExtremityPeripheral Arterial DiseasePredictive Value of TestsTreatment OutcomeConceptsPeripheral artery diseaseAnkle-brachial indexToe-brachial indexElectronic health recordsABI testingVeterans Affairs electronic health recordsHealth recordsStructured chart reviewVeterans Affairs facilitiesPositive predictive valuePAD patientsChart reviewArtery diseaseClinical dataClinical impactHigh prevalenceBilling codesSeparate cohortPredictive valuePatientsClinical expertsPAD researchRandom sampleLateralityReportThe Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk
Smolderen KG, Heath K, Scherr T, Bauzon SR, Howell AN, Mena-Hurtado C. The Nevada peripheral artery disease screening effort in a Medicare Advantage population and subsequent mortality and major adverse cardiovascular event risk. Journal Of Vascular Surgery 2022, 75: 2054-2064.e3. PMID: 35181520, DOI: 10.1016/j.jvs.2022.01.134.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overFemaleHumansLower ExtremityMaleMedicare Part CNevadaPeripheral Arterial DiseaseRisk FactorsUnited StatesConceptsMajor adverse cardiovascular eventsPeripheral artery diseaseUnadjusted hazard ratioLower extremity peripheral artery diseaseHazard ratioMedicare Advantage beneficiariesCause mortalityElectronic medical recordsArtery diseaseMajor adverse cardiovascular event riskAdverse cardiovascular eventsAtherosclerotic risk factorsMedicare Advantage populationCardiovascular event riskAnnual health assessmentPrimary care providersPatients' electronic medical recordsRisk of mortalityScreening resultsPositive screening resultsMACE ratePAD screeningCardiovascular eventsMultivariable adjustmentScreening status
2021
Safety and efficacy outcomes of the Pioneer Plus catheter in endovascular revascularization of lower extremity chronic total occlusions
Sheikh AB, Llanos-Chea F, Jelani QU, Anantha-Narayanan M, Attaran R, Schneider M, Ionescu C, Regan C, Nagpal S, Smolderen KG, Mena-Hurtado C. Safety and efficacy outcomes of the Pioneer Plus catheter in endovascular revascularization of lower extremity chronic total occlusions. Journal Of Vascular Surgery 2021, 74: 746-755. PMID: 33592298, DOI: 10.1016/j.jvs.2021.01.045.Peer-Reviewed Original ResearchConceptsMajor adverse limb eventsAdverse limb eventsDevice-related complicationsProcedure-related complicationsProcedure-related outcomesProcedural successEfficacy outcomesPseudoaneurysm formationSafety outcomesLimb eventsLower extremity chronic total occlusionMajor adverse cardiovascular eventsChronic total occlusion interventionAccess site hematomaAcute arterial thrombosisAcute limb ischemiaAdverse cardiovascular eventsProvider-level factorsArteriovenous fistula formationHigh-volume centersChronic total occlusionMajor bleedingPreprocedural symptomsCardiovascular eventsCatheter useContemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia
Anantha-Narayanan M, Doshi RP, Patel K, Sheikh AB, Llanos-Chea F, Abbott JD, Shishehbor MH, Guzman RJ, Hiatt WR, Duval S, Mena-Hurtado C, Smolderen KG. Contemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007539. PMID: 33541110, DOI: 10.1161/circoutcomes.120.007539.Peer-Reviewed Original ResearchConceptsLength of stayMajor amputationCost of hospitalizationHospital mortalitySurgical interventionEndovascular interventionBlack raceHigh-risk patient profileNational Inpatient Sample dataHigher major amputationMore endovascular interventionsRisk patient profileCritical limb ischemiaOpen surgical interventionMultivariable regression analysisHierarchical multivariable regression analysisCLI cohortHospital admissionLimb ischemiaPrimary outcomeRevascularization proceduresSecondary outcomesAtherosclerotic diseaseMale sexFemale sex
2020
Association of Health Status Scores With Cardiovascular and Limb Outcomes in Patients With Symptomatic Peripheral Artery Disease: Insights From the EUCLID (Examining Use of Ticagrelor in Symptomatic Peripheral Artery Disease) Trial
Rymer JA, Mulder H, Smolderen KG, Hiatt WR, Conte MS, Berger JS, Norgren L, Mahaffey KW, Baumgartner I, Fowkes FG, Katona BG, Rockhold F, Jones WS, Patel MR. Association of Health Status Scores With Cardiovascular and Limb Outcomes in Patients With Symptomatic Peripheral Artery Disease: Insights From the EUCLID (Examining Use of Ticagrelor in Symptomatic Peripheral Artery Disease) Trial. Journal Of The American Heart Association 2020, 9: e016573. PMID: 32924754, PMCID: PMC7792388, DOI: 10.1161/jaha.120.016573.Peer-Reviewed Original ResearchMeSH KeywordsCardiovascular DiseasesDouble-Blind MethodFemaleHealth Status IndicatorsHumansLower ExtremityMaleMiddle AgedOutcome Assessment, Health CarePeripheral Arterial DiseasePlatelet Aggregation InhibitorsQuality of LifeSurveys and QuestionnairesSymptom AssessmentTicagrelorVascular Surgical ProceduresVisual Analog ScaleConceptsMajor adverse cardiovascular eventsMajor adverse limb eventsAdverse cardiovascular eventsAdverse limb eventsLower extremity revascularizationPeripheral artery diseaseCardiovascular eventsHealth status instrumentsLimb eventsEUCLID trialVAS scoresArtery diseaseEQ-5DQuestionnaire scoresSubsequent major adverse cardiovascular eventsLow ankle-brachial indexSymptomatic peripheral artery diseaseLower extremity revascularization proceduresBaseline EQ-5DAnkle-brachial indexHealth status scoresEQ-5D scoresHealth status measurementHealth status changesSubsequent end pointsSystematic review and meta-analysis of outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease
Anantha-Narayanan M, Sheikh AB, Nagpal S, Jelani QU, Smolderen KG, Regan C, Ionescu C, Ochoa Chaar CI, Schneider M, Llanos-Chea F, Mena-Hurtado C. Systematic review and meta-analysis of outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease. Journal Of Vascular Surgery 2020, 73: 331-340.e4. PMID: 32889074, DOI: 10.1016/j.jvs.2020.08.032.Peer-Reviewed Original ResearchConceptsCKD/end-stage renal diseaseEnd-stage renal diseaseNormal renal functionChronic kidney diseaseTarget lesion revascularizationLong-term mortalityPeripheral arterial diseaseRenal functionPAD interventionsMajor amputationRenal diseaseKidney diseaseOdds ratioNormal renal function groupIntervention typeRenal function groupCritical limb ischemiaPeripheral arterial interventionsConfidence intervalsPooled odds ratioOpen surgical approachMultivariable regression analysisCase-control matchingRandom-effects modelEvidence-based strategies
2015
Long‐Term Prognostic Risk in Lower Extremity Peripheral Arterial Disease as a Function of the Number of Peripheral Arterial Lesions
Smolderen KG, van Zitteren M, Jones PG, Spertus JA, Heyligers JM, Nooren MJ, Vriens PW, Denollet J. Long‐Term Prognostic Risk in Lower Extremity Peripheral Arterial Disease as a Function of the Number of Peripheral Arterial Lesions. Journal Of The American Heart Association 2015, 4: e001823. PMID: 26504149, PMCID: PMC4845133, DOI: 10.1161/jaha.115.001823.Peer-Reviewed Original ResearchMeSH KeywordsAgedArteriesChi-Square DistributionDisease ProgressionFemaleHumansKaplan-Meier EstimateLower ExtremityMaleMiddle AgedMultivariate AnalysisNetherlandsPeripheral Arterial DiseasePredictive Value of TestsPrognosisProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsUltrasonography, Doppler, DuplexConceptsLower extremity lesionsPeripheral artery diseasePAD patientsAdverse prognosisExtremity lesionsLower Extremity Peripheral Arterial DiseaseSimple risk stratification toolDuplex ultrasound testingPeripheral arterial lesionsClinical risk factorsPeripheral arterial diseaseFirst adverse eventGreater disease burdenLong-term prognosisRisk stratification toolPAD diagnosisAdverse eventsProspective cohortArtery diseaseArterial diseaseArterial lesionsPrognostic riskDisease burdenIndependent associationRisk factors
2014
Determinants of invasive treatment in lower extremity peripheral arterial disease
van Zitteren M, Vriens PW, Burger DH, de Fijter WM, Gerritsen GP, Heyligers JM, Nooren MJ, Smolderen KG. Determinants of invasive treatment in lower extremity peripheral arterial disease. Journal Of Vascular Surgery 2014, 59: 400-408.e2. PMID: 24461863, DOI: 10.1016/j.jvs.2013.08.045.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnkle Brachial IndexChi-Square DistributionDecision Support TechniquesEndovascular ProceduresFemaleHealth StatusHumansLower ExtremityMaleMiddle AgedNetherlandsOdds RatioPatient SelectionPeripheral Arterial DiseasePredictive Value of TestsProspective StudiesReferral and ConsultationRisk FactorsTreatment OutcomeUltrasonography, Doppler, DuplexVascular Surgical ProceduresConceptsPeripheral arterial diseaseLower extremity peripheral arterial diseasePhysical component scaleInvasive treatmentLesion locationHealth statusArterial diseaseTreatment referralSymptomatic lower extremity peripheral arterial diseaseProspective observational cohort studyVascular surgery outpatient clinicProximal lesion locationAnkle-brachial indexObservational cohort studySurgery outpatient clinicShort Form-12Poor health statusPatients' health statusPoisson regression analysisPAD diagnosisCohort studyPAD symptomsIndependent predictorsAmbulatory patientsForm-12
2012
Self-reported symptoms on questionnaires and anatomic lesions on duplex ultrasound examinations in patients with peripheral arterial disease
van Zitteren M, Vriens PW, Heyligers JM, Burger DH, Nooren MJ, de Fijter WM, Denollet J, Smolderen KG. Self-reported symptoms on questionnaires and anatomic lesions on duplex ultrasound examinations in patients with peripheral arterial disease. Journal Of Vascular Surgery 2012, 55: 1025-1034.e2. PMID: 22244858, DOI: 10.1016/j.jvs.2011.10.115.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsCross-Sectional StudiesFemaleFollow-Up StudiesHumansIntermittent ClaudicationLogistic ModelsLower ExtremityMaleMultivariate AnalysisOdds RatioPain MeasurementPeripheral Arterial DiseaseRisk FactorsSelf ReportSeverity of Illness IndexSurveys and QuestionnairesUltrasonography, Doppler, DuplexConceptsPeripheral arterial diseaseCardiovascular risk factorsDuplex ultrasound examinationDistal lesionsProximal lesionsLesion locationLeg symptomsPatient characteristicsSelf-reported symptomsArterial diseaseRisk factorsUltrasound examinationLower extremity peripheral arterial diseaseVascular surgery outpatient clinicMultivariable logistic regression analysisExertional leg symptomsNew-onset symptomsCardiovascular risk profileSurgery outpatient clinicMain outcome measuresCross-sectional studyFurther diagnostic imagingLogistic regression analysisTailor-made managementPAD subgroups
2009
Lower-leg symptoms in peripheral arterial disease are associated with anxiety, depression, and anhedonia
Smolderen KG, Hoeks SE, Pedersen SS, van Domburg RT, de Liefde II, Poldermans D. Lower-leg symptoms in peripheral arterial disease are associated with anxiety, depression, and anhedonia. Vascular Medicine 2009, 14: 297-304. PMID: 19808714, DOI: 10.1177/1358863x09104658.Peer-Reviewed Original ResearchConceptsAtypical leg symptomsPeripheral arterial diseaseExertional leg symptomsAnkle-brachial indexLeg symptomsIntermittent claudicationDepressive symptomsPAD patientsClinical factorsArterial diseaseAnkle-brachial index screeningSan Diego Claudication QuestionnaireClassic intermittent claudicationConsecutive PAD patientsLower leg symptomsDiverse clinical manifestationsErasmus Medical CenterMood statesSub-threshold symptomsCardiovascular historyMedication useTwofold riskClinical manifestationsPoor prognosisHospital Anxiety