학술논문
Disparities in Diagnosis, Treatment, and Outcomes of Peripheral Artery Disease: JACC Scientific Statement.
Document Type
Academic Journal
Author
McDermott MM; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Electronic address: mdm608@northwestern.edu.; Ho KJ; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Alabi O; Emory University School of Medicine, Atlanta, Georgia, USA.; Criqui MH; University of California-San Diego, School of Medicine, La Jolla, California, USA.; Goodney P; Dartmouth School of Medicine, Hanover, New Hampshire, USA.; Hamburg N; Boston Medical Center, Boston, Massachusetts, USA.; McNeal DM; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA.; Pollak A; Mayo Clinic Jacksonville, Jacksonville, Florida, USA.; Smolderen KG; Yale University School of Medicine, New Haven, Connecticut, USA.; Bonaca M; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA.
Source
Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
Subject
Language
English
Abstract
Disparities by sex, race, socioeconomic status, and geography exist in diagnosis, treatment, and outcomes for people with lower extremity peripheral artery disease (PAD). PAD prevalence is similar in men and women, but women have more atypical symptoms and undergo lower extremity revascularization at older ages compared to men. People who are Black have an approximately 2-fold higher prevalence of PAD, compared to people who are White and have more atypical symptoms, greater mobility loss, less optimal medical care, and higher amputation rates. Although fewer data are available for other races, people with PAD who are Hispanic have higher amputation rates than White people. Rates of amputation also vary by geography in the United States, with the highest rates of amputation in the southeastern United States. To improve PAD outcomes, intentional actions to eliminate disparities are necessary, including clinician education, patient education with culturally appropriate messaging, improved access to high-quality health care, science focused on disparity elimination, and health policy changes.
Competing Interests: Funding Support and Author Disclosures Dr McDermott has received grant funding from Helixmith; and has received other research support from ArtAssist, Chromadex, ReserveAge, Mars, and Helixmith. Dr Hamburg has received honoraria from Novo Nordisk and Boston Scientific. Dr Pollak is a member of the Janssen Health Equity advisory group (unpaid). Dr Bonaca is the executive director of CPC, a nonprofit academic research organization affiliated with the University of Colorado, that receives or has received research grant and consulting funding between February 2021 and the present from Abbott Laboratories, Adamis Pharmaceuticals, Agios Pharmaceuticals, Alexion Pharma, Alnylam Pharmaceuticals, Amgen, Angionetics, ARCA Biopharma, Array BioPharma, AstraZeneca and Affiliates, Atentiv, Audentes Therapeutics, Bayer and Affiliates, Beth Israel Deaconess Medical Center, Better Therapeutics, Boston Clinical Research Institute, Bristol Myers Squibb, Cambrian Biopharma, Cardiol Therapeutics, CellResearch, Cook Medical, Covance, CSL Behring, Eidos Therapeutics, EP Trading, EPG Communication Holdings, Epizon Pharma, Esperion Therapeutics, Everly Well, Exicon Consulting, Faraday Pharmaceuticals, Foresee Pharmaceuticals, Fortress Biotech, HDL Therapeutics, HeartFlow, Hummingbird Bioscience, Insmed, Ionis Pharmaceuticals, IQVIA, JanOne Biotech Holdings, Janssen and Affiliates, Kaneka, Kowa Research Institute, Kyushu University, Lexicon Pharmaceuticals, LSG Kyushu University, Medimmune, Medpace, Merck & Affiliates, Novartis Pharmaceuticals, Novate Medical, Novo Nordisk, Pan Industry Group, Pfizer, PhaseBio Pharmaceuticals, PPD Development, Prairie Education and Research Cooperative, Prothena Biosciences, Regeneron Pharmaceuticals, Regio Biosciences, Rexgenero, Sanifit Therapeutics, Sanofi, Silence Therapeutics, Smith & Nephew, Stealth BioTherapeutics, the State of Colorado CCPD Grant, Brigham & Women’s Hospital, the Feinstein Institutes for Medical Research, the Thrombosis Research Institute, the University of Colorado, the University of Pittsburgh, VarmX, Virta Health, WCT Atlas, Worldwide Clinical Trials, WraSer, and Yale Cardiovascular Research Group; has received support from the American Heart Association Strategically Focused Research Network under awards 18SFRN3390085 (BWH-DH SFRN Center) and 18SFRN33960262 (BWH-DH Clinical Project); has modest stock holdings in Medtronic and Pfizer; and has received consulting fees from Audentes. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Competing Interests: Funding Support and Author Disclosures Dr McDermott has received grant funding from Helixmith; and has received other research support from ArtAssist, Chromadex, ReserveAge, Mars, and Helixmith. Dr Hamburg has received honoraria from Novo Nordisk and Boston Scientific. Dr Pollak is a member of the Janssen Health Equity advisory group (unpaid). Dr Bonaca is the executive director of CPC, a nonprofit academic research organization affiliated with the University of Colorado, that receives or has received research grant and consulting funding between February 2021 and the present from Abbott Laboratories, Adamis Pharmaceuticals, Agios Pharmaceuticals, Alexion Pharma, Alnylam Pharmaceuticals, Amgen, Angionetics, ARCA Biopharma, Array BioPharma, AstraZeneca and Affiliates, Atentiv, Audentes Therapeutics, Bayer and Affiliates, Beth Israel Deaconess Medical Center, Better Therapeutics, Boston Clinical Research Institute, Bristol Myers Squibb, Cambrian Biopharma, Cardiol Therapeutics, CellResearch, Cook Medical, Covance, CSL Behring, Eidos Therapeutics, EP Trading, EPG Communication Holdings, Epizon Pharma, Esperion Therapeutics, Everly Well, Exicon Consulting, Faraday Pharmaceuticals, Foresee Pharmaceuticals, Fortress Biotech, HDL Therapeutics, HeartFlow, Hummingbird Bioscience, Insmed, Ionis Pharmaceuticals, IQVIA, JanOne Biotech Holdings, Janssen and Affiliates, Kaneka, Kowa Research Institute, Kyushu University, Lexicon Pharmaceuticals, LSG Kyushu University, Medimmune, Medpace, Merck & Affiliates, Novartis Pharmaceuticals, Novate Medical, Novo Nordisk, Pan Industry Group, Pfizer, PhaseBio Pharmaceuticals, PPD Development, Prairie Education and Research Cooperative, Prothena Biosciences, Regeneron Pharmaceuticals, Regio Biosciences, Rexgenero, Sanifit Therapeutics, Sanofi, Silence Therapeutics, Smith & Nephew, Stealth BioTherapeutics, the State of Colorado CCPD Grant, Brigham & Women’s Hospital, the Feinstein Institutes for Medical Research, the Thrombosis Research Institute, the University of Colorado, the University of Pittsburgh, VarmX, Virta Health, WCT Atlas, Worldwide Clinical Trials, WraSer, and Yale Cardiovascular Research Group; has received support from the American Heart Association Strategically Focused Research Network under awards 18SFRN3390085 (BWH-DH SFRN Center) and 18SFRN33960262 (BWH-DH Clinical Project); has modest stock holdings in Medtronic and Pfizer; and has received consulting fees from Audentes. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)