McDermott Mary M, Kadian-Dodov Daniella, Aronow Herbert A, Beckman Joshua A, Bolden Demetria M, Castro-Dominguez Yulanka S, Creager Mark A, Criqui Michael H, Goodney Philip P, Gornik Heather L, Hamburg Naomi M, Leeper Nicholas J, Olin Jeffrey W, Ross Elsie, Bonaca Marc P
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
The Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Vasc Med. 2025 Jun;30(3):367-383. doi: 10.1177/1358863X251330583. Epub 2025 May 1.
Lower-extremity peripheral artery disease (PAD) affects approximately 236 million people worldwide and at least eight million people in the United States (US). Despite availability of new therapies that prevent major adverse cardiovascular events (MACE), these and major adverse limb events (MALE) remain common and occur more frequently in people with PAD, either with or without coronary artery disease (CAD), compared to people with CAD who do not have PAD. The most effective therapies to prevent cardiovascular events are not identical in people with PAD and those with CAD. Walking impairment and the risk of lower-extremity amputation are significantly greater in people with PAD compared to those without PAD. This report from the Society for Vascular Medicine (SVM) proposes and summarizes high-priority topics for scientific investigation in PAD, with the goal of improving health outcomes in people with PAD. To develop this report, a multidisciplinary team of scientists and clinicians reviewed literature, proposed high-priority topics for scientific investigation, and voted to rank the highest priority topics for scientific investigation. Priorities for clinical scientific investigation include: determine the current prevalence of PAD in the US by age, sex, race, and ethnicity; improve methods to diagnose PAD; develop new medical therapies to eliminate walking impairment; and improve implementation of established therapies to reduce rates of MACE and MALE in people with PAD. Priorities in basic science and translational science investigation include: developing animal models that closely resemble the vascular, skeletal muscle, and platelet pathology in patients with PAD and defining the genetic and epigenetic contributors to PAD and PAD-associated outcomes. Successful investigation of these research priorities will require more well-trained investigators focused on scientific investigation of PAD, greater and more efficient enrollment of diverse patients with PAD in randomized clinical trials, and increased research funding dedicated to PAD.
下肢外周动脉疾病（PAD）在全球约影响2.36亿人，在美国至少影响800万人。尽管有预防主要不良心血管事件（MACE）的新疗法，但这些事件以及主要不良肢体事件（MALE）仍然常见，并且与没有PAD的冠心病（CAD）患者相比，无论有无CAD，PAD患者发生这些事件的频率更高。预防心血管事件的最有效疗法在PAD患者和CAD患者中并不相同。与没有PAD的人相比，PAD患者的行走障碍和下肢截肢风险明显更高。血管医学协会（SVM）的这份报告提出并总结了PAD科学研究的高优先级主题，目标是改善PAD患者的健康结局。为撰写本报告，一个由科学家和临床医生组成的多学科团队查阅了文献，提出了科学研究的高优先级主题，并投票选出科学研究的最高优先级主题。临床科学研究的重点包括：按年龄、性别、种族和族裔确定美国目前PAD的患病率；改进PAD的诊断方法；开发新的医学疗法以消除行走障碍；以及改进既定疗法的实施，以降低PAD患者的MACE和MALE发生率。基础科学和转化科学研究的重点包括：开发与PAD患者的血管、骨骼肌和血小板病理学非常相似的动物模型，以及确定PAD和PAD相关结局的遗传和表观遗传因素。要成功开展这些研究重点，将需要更多训练有素的研究人员专注于PAD的科学研究，在随机临床试验中更大量、更高效地招募不同的PAD患者，并增加专门用于PAD的研究资金。
