Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia.
Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia.
Trends Cardiovasc Med. 2021 Aug;31(6):351-358. doi: 10.1016/j.tcm.2020.06.005. Epub 2020 Jun 19.
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.
下肢早发动脉粥样硬化性外周动脉疾病（PAD）的特征是在 50 岁之前诊断出疾病。全球早发 PAD 的患病率有所增加，由于患者症状存在异质性，该疾病往往未得到充分诊断。传统心血管危险因素，如吸烟、糖尿病、高血压、高血脂，以及非传统危险因素，如脂蛋白(a)升高、PAD 家族史、高凝状态和全身炎症，均与早发 PAD 相关。早发 PAD 患者的血管疾病进程往往具有侵袭性，心血管危险因素负担较重，且常伴有其他动脉粥样硬化性血管疾病，如冠状动脉疾病。预防心血管事件、改善症状和功能状态以及预防不良肢体事件是患者管理的主要目标。在这篇综述中，我们讨论了早发 PAD 患者的流行病学、危险因素、临床评估和管理。
