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  2. Peripheral Arterial Disease
IJCS
Original Article

Systemic Inflammation, Fibrinogen, and Lipoprotein(a) as Composite Predictors of Peripheral Arterial Disease

Alim Namitokov et al. Karina Karabakhtsieva Irina Gilevich

Abstract

Background:

Early detection of peripheral atherosclerosis remains a clinical challenge, especially in asymptomatic individuals. This study aimed to evaluate the predictive value of systemic inflammatory indices and lipid-related biomarkers for early atherosclerosis.

Objectives:

To investigate the diagnostic value of systemic inflammation indices, fibrinogen, and lipoprotein(a) as individual biomarkers and as a combined predictive model for early peripheral arterial disease.

Methods:

A prospective case-control study was conducted in 54 individuals: 20 patients diagnosed with early peripheral atherosclerosis (<55 years) and 34 healthy controls. Laboratory data included complete blood count, lipid profile, fibrinogen, lipoprotein(a), angiopoietin-like protein 3 (ANGPTL3), and Lp-PLA2. Inflammatory indices, including NLR, PLR, SII, SIRI, AISI, and MLR, were calculated. Logistic regression and ROC analysis were performed. A two-sided p-value < 0.05 was considered statistically significant.

Results:

SIRI (1.70 vs. 0.93, p = 0.0039) and AISI (431.6 vs. 236.4, p = 0.0128) were significantly higher in the atherosclerosis group. Fibrinogen showed the most robust association (5.46 vs. 3.71 g/L, p < 0.00001). Lp(a) alone was not statistically different between groups but improved the multivariate model (AUC 0.85 vs. 0.82). The final model, including age, inflammatory indices, LDL, Lp (a), and fibrinogen, achieved an AUC of 0.91.

Conclusion:

Systemic inflammation and fibrinogen levels are strongly associated with early atherosclerosis. Their combination with lipoprotein(a) enhances diagnostic performance, offering a simple, cost-effective strategy for early vascular risk assessment.

  • Atherosclerosis
  • Biomarkers
  • Fibrinogen
  • Inflammation
  • Lipoprotein(a)
  • Peripheral Arterial Disease
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Creative Commons Attribution (CC BY) Creative Commons license
25/05/2026 DOI: 10.36660/ijcs.20250165 Visualizações 9
IJCS
Original Article

Effects of Noninvasive Electrostimulation on Symptoms of lower Limb Peripheral Arterial Disease: a Systematic Review

Ana Paula Ferreira et al. Ana Flávia Ferreira Plinio dos Santos Ramos Thiago Casali Rocha Djalma Rabelo Ricardo

Abstract

Background:

Peripheral arterial disease (PAD) is primarily characterized by intermittent claudication (IC), a symptom resulting from insufficient oxygen supply to skeletal muscles during physical activity. IC manifests as discomfort in the lower limbs during exertion due to muscle ischemia and is typically relieved by rest.

Objectives:

To evaluate the effects of noninvasive electrostimulation on walking distance and claudication-related pain in individuals with lower limb PAD.

Methods:

This systematic review was conducted in accordance with PRISMA guidelines. Clinical trials published in English, Portuguese, or Spanish were selected from the MedLine, PEDro, and SciELO databases up to December 2024. The search strategy was guided by the PICO framework, using descriptors related to “peripheral artery disease,” “intermittent claudication,” and “noninvasive electrostimulation.” Studies were included if they involved human participants diagnosed with PAD and presenting with Fontaine stage II intermittent claudication.

Results:

Seven clinical trials involving a total of 314 participants (mean age: 66.8 ± 3.6 years) were included. Four types of noninvasive electrostimulation were identified: neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), functional electrical stimulation (FES), and electroacupuncture. Most studies reported that electrostimulation improved both pain-free and maximum walking distances, as well as reduced claudication symptoms.

Conclusion:

Noninvasive electrostimulation appears to be a promising adjunctive therapy for individuals with peripheral arterial disease, offering potential benefits in symptom relief and walking capacity. Given its safety, low cost, and ease of application, this intervention may serve as a practical strategy to complement traditional treatment approaches. However, further high-quality clinical trials are needed to establish standardized protocols and optimize clinical outcomes.

  • Electrostimulation
  • Intermittent Claudication
  • Peripheral Arterial Disease
  • Transcutaneous Electrical Nerve Stimulation
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Creative Commons Attribution (CC BY) Creative Commons license
16/02/2026 DOI: 10.36660/ijcs.20250047 Visualizações 14
IJCS
Original Article

The Influence of Primary Atherosclerotic Diseases on the Occurrence of Secondary Disease

Paula Monique Chiconi de Picoli et al. Creusa Sayuri Tahara Amaral Eliane Trovatti

Abstract

Background

Atherosclerosis is a condition in which fats, cholesterol, fibrin, and other substances accumulate into plaque on the arterial walls. Plaque can harden and narrow the arteries, in turn limiting the blood flow and resulting in diseases, such as acute myocardial infarction (AMI), ischemic stroke (IS), or peripheral arterial disease (PAD). There is a fairly high risk of a secondary atherosclerotic event if patients are not treated after the primary episode.

Objective

To calculate the statistical probability of developing AMI, IS, or PAD after treating the primary disease.

Methods

Data for statistical probability studies included 507,690 patients with primary atherosclerotic disease, who were in treatment during the study period and who did or did not develop a secondary atherosclerotic disease event.

Result

Statistical probability data indicate that few AMI patients can develop IS (2.99%) or PAD (2.86%) as a secondary disease. Patients with primary diagnoses of IS showed a 5.07% risk of developing PAD and a 0.95% risk of developing AMI; however, PAD patients showed a higher probability for both AMI (9.17%) and IS (8.79%).

Conclusion

Secondary atherosclerotic disease episodes after IS, AMI, and PAD were confirmed by statistical probability and are consistent with data from the literature. The study revealed that a primary PAD event leads to high rates of secondary episodes, and special attention should be given to the diagnosis and treatment of PAD in order to decrease the occurrence of secondary events.

  • Aging
  • Amputation
  • Cerebrovascular Disease
  • Diabetes mellitus
  • Lower Extremity
  • Myocardial Ischemia
  • Peripheral Arterial Disease
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Creative Commons Attribution (CC BY) Creative Commons license
01/08/2022 DOI: 10.36660/ijcs.20210251 Visualizações 8

Como citar este artigo

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Namitokov A, Karabakhtsieva K, Gilevich I. Systemic Inflammation, Fibrinogen, and Lipoprotein(a) as Composite Predictors of Peripheral Arterial Disease. International Journal of Cardiovascular Sciences 2026;39:e20250165.

Formato de Documento Eletrônico (ABNT)

Namitokov, Alim; Karabakhtsieva, Karina; Gilevich, Irina. Systemic Inflammation, Fibrinogen, and Lipoprotein(a) as Composite Predictors of Peripheral Arterial Disease. International Journal of Cardiovascular Sciences, v. 39, e20250165, maio. 2026.

Formato de Documento Eletrônico (APA)

Namitokov, A., Karabakhtsieva, K., & Gilevich, I. (2026). Systemic Inflammation, Fibrinogen, and Lipoprotein(a) as Composite Predictors of Peripheral Arterial Disease. International Journal of Cardiovascular Sciences, 39, e20250165.

Formato de Documento Eletrônico (ISO)

Namitokov, Alim and Karabakhtsieva, Karina and Gilevich, Irina. Systemic Inflammation, Fibrinogen, and Lipoprotein(a) as Composite Predictors of Peripheral Arterial Disease. International Journal of Cardiovascular Sciences [online]. 2026, vol. 39, [citado 2026-11-15], e20250165. Disponível em: <https://journals.cardiol.br/article/systemic-inflammation-fibrinogen-and-lipoproteina-as-composite-predictors-of-peripheral-arterial-disease-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Ferreira AP, Ferreira AF, Ramos PS, Rocha TC, Ricardo DR. Effects of Noninvasive Electrostimulation on Symptoms of lower Limb Peripheral Arterial Disease: a Systematic Review. International Journal of Cardiovascular Sciences 2026;38:e20250047.

Formato de Documento Eletrônico (ABNT)

Ferreira, Ana Paula; Ferreira, Ana Flávia; Ramos, Plinio dos Santos; Rocha, Thiago Casali; Ricardo, Djalma Rabelo. Effects of Noninvasive Electrostimulation on Symptoms of lower Limb Peripheral Arterial Disease: a Systematic Review. International Journal of Cardiovascular Sciences, v. 38, e20250047, fev. 2026.

Formato de Documento Eletrônico (APA)

Ferreira, A. P., Ferreira, A. F., Ramos, P. S., Rocha, T. C., & Ricardo, D. R. (2026). Effects of Noninvasive Electrostimulation on Symptoms of lower Limb Peripheral Arterial Disease: a Systematic Review. International Journal of Cardiovascular Sciences, 38, e20250047.

Formato de Documento Eletrônico (ISO)

Ferreira, Ana Paula and Ferreira, Ana Flávia and Ramos, Plinio dos Santos and Rocha, Thiago Casali and Ricardo, Djalma Rabelo. Effects of Noninvasive Electrostimulation on Symptoms of lower Limb Peripheral Arterial Disease: a Systematic Review. International Journal of Cardiovascular Sciences [online]. 2026, vol. 38, [citado 2026-11-15], e20250047. Disponível em: <https://journals.cardiol.br/article/effects-of-noninvasive-electrostimulation-on-symptoms-of-lower-limb-peripheral-arterial-disease-a-systematic-review-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Picoli PMC, Amaral CST, Trovatti E. The Influence of Primary Atherosclerotic Diseases on the Occurrence of Secondary Disease. International Journal of Cardiovascular Sciences 2022;36:e20210251.

Formato de Documento Eletrônico (ABNT)

Picoli, Paula Monique Chiconi de; Amaral, Creusa Sayuri Tahara; Trovatti, Eliane. The Influence of Primary Atherosclerotic Diseases on the Occurrence of Secondary Disease. International Journal of Cardiovascular Sciences, v. 36, e20210251, jul. 2022.

Formato de Documento Eletrônico (APA)

Picoli, P. M. C. , Amaral, C. S. T., & Trovatti, E. (2022). The Influence of Primary Atherosclerotic Diseases on the Occurrence of Secondary Disease. International Journal of Cardiovascular Sciences, 36, e20210251.

Formato de Documento Eletrônico (ISO)

Picoli, Paula Monique Chiconi de and Amaral, Creusa Sayuri Tahara and Trovatti, Eliane. The Influence of Primary Atherosclerotic Diseases on the Occurrence of Secondary Disease. International Journal of Cardiovascular Sciences [online]. 2022, vol. 36, [citado 2026-11-15], e20210251. Disponível em: <https://journals.cardiol.br/article/the-influence-of-primary-atherosclerotic-diseases-on-the-occurrence-of-secondary-disease-4/>. ISSN 2359-4802

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