Jeffrey W Olin

PreambleSince 1980, the American College of Cardiology (ACC) and American Heart

Association (AHA) have translated scientific evidence into clinical practice

guidelines with recommendations to improve cardiovascular health. These

guidelines, based on systematic methods to evaluate and classify evidence,

provide a cornerstone of quality cardiovascular care.In response to reports from the Institute of Medicine1,2

and a mandate to evaluate new knowledge and maintain relevance at the point ...

CONTEXT: Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis that is common and is associated with an increased risk of death and ischemic events, yet may be underdiagnosed in primary care practice.

OBJECTIVE: To assess the feasibility of detecting PAD in primary care clinics, patient and physician awareness of PAD, and intensity of risk factor treatment and use of antiplatelet therapies in primary care clinics.

DESIGN AND SETTING: The PAD Awareness, Risk, ...

BACKGROUND: Fibromuscular dysplasia (FMD) is a noninflammatory arterial disease that predominantly affects women. The arterial manifestations may include beading, stenosis, aneurysm, dissection, or tortuosity.

OBJECTIVES: This study compared the frequency, location, and outcomes of FMD patients with aneurysm and/or dissection to those of patients without.

METHODS: The U.S. Registry for FMD involves 12 clinical centers. This analysis included clinical history, diagnostic, and therapeutic ...

BACKGROUND: Vorapaxar is a novel antagonist of protease-activated receptor-1, the primary receptor for thrombin on human platelets that is also present on vascular endothelium and smooth muscle. Patients with peripheral artery disease are at risk of systemic atherothrombotic events, as well as acute and chronic limb ischemia and the need for peripheral revascularization.

METHODS AND RESULTS: The Trial to Assess the Effects of SCH 530348 in Preventing Heart Attack and Stroke in Patients ...

Peripheral arterial disease (PAD) has been demonstrated to be prevalent in the primary care setting. However, it has also been shown to be unrecognized and under-treated. Owing to the association with cardiovascular disease it has been recommended to screen high-risk patients for PAD in the primary care setting using the ankle-brachial index (ABI). ABI has been demonstrated to be highly sensitive and specific in diagnosing PAD in patients with significant stenosis. However, the utility ...

Renal artery stenosis (RAS) may cause hypertension, azotemia, episodes of flash pulmonary edema and congestive heart failure. Renal artery angioplasty and stenting was performed in 207 patients from 1991 to 1997. Thirty-nine of these patients (19%) underwent renal artery stenting for the control of recurrent episodes of congestive heart failure and flash pulmonary edema. All patients had angiographic evidence of severe (>70%) bilateral RAS (n = 18) or severe RAS to a solitary functioning ...

BACKGROUND: Patients with peripheral artery disease (PAD) are at heightened risk of acute limb ischemia (ALI), a morbid event that may result in limb loss. We investigated the causes, sequelae, and predictors of ALI in a contemporary population with symptomatic PAD and whether protease-activated receptor 1 antagonism with vorapaxar reduced ALI overall and by type.

METHODS AND RESULTS: The Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With ...

Intensive antithrombotic therapy reduces major adverse cardiovascular events (MACE) and major adverse limb events (MALE) in patients with peripheral artery disease (PAD). Recent studies have suggested heterogeneity in risk and benefit in those with and without concomitant coronary artery disease (CAD) and peripheral revascularization. We evaluated the risk of MACE and MALE in patients with PAD stratified by history of concomitant CAD and prior peripheral revascularization and whether the ...

OBJECTIVES: This study sought to evaluate the short-, intermediate-, and longer-term outcomes after endovascular versus open repair of abdominal aortic aneurysms (AAA), including both AAA-related and all-cause mortality.

BACKGROUND: Endovascular stent graft placement for AAA has gained broad acceptance as an alternative to open surgical repair due to a lower perioperative morbidity and mortality. The intermediate- and long-term all-cause and aneurysm-related mortality vary among studies. ...

PreambleSince 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines with recommendations to improve cardiovascular health. These guidelines, based on systematic methods to evaluate and classify evidence, provide a cornerstone of quality cardiovascular care.In response to reports from the Institute of Medicine1,2 and a mandate to evaluate new knowledge and maintain relevance at the point of ...

Importance: The prevalence of intracranial aneurysm in patients with fibromuscular dysplasia (FMD) is uncertain.

Objective: To examine the prevalence of intracranial aneurysm in women diagnosed with FMD.

Design, Setting, and Participants: This cross-sectional study included 669 women with intracranial imaging registered in the US Registry for Fibromuscular Dysplasia, an observational disease-based registry of patients with FMD confirmed by vascular imaging and currently enrolling at 14 ...

PURPOSE: To evaluate the efficacy of intravascular stents used to treat long-segment stenoses and occlusions of the superficial femoral artery (SFA) after suboptimal angioplasty.

METHODS: Fifty-eight limbs in 55 patients who underwent stenting of the SFA were identified from a vascular registry. Indications for stent placement after suboptimal PTA included flow-limiting dissection, residual pressure gradient (>15 mm Hg) or stenosis (>30%), or failure to establish initial patency. Lesion ...

OBJECTIVES: In the current study, we hypothesized that beraprost would: 1) improve treadmill exercise performance and quality of life; and 2) decrease rates of ischemic events in patients with intermittent claudication.

BACKGROUND: Previous trials with beraprost sodium, an orally active prostaglandin I(2) analogue, in the treatment of claudication in patients with peripheral arterial disease (PAD) have been inconsistent.

METHODS: Patients with intermittent claudication (n = 897) were ...