Title: The Potential Role of Antioxidants in the Treatment of Peripheral Arterial Disease: A Systematic Review

Abstract:

Statement of the Problem: Peripheral arterial disease (PAD) has a worldwide prevalence and is a significant cause of cardiovascular morbidity and mortality. Due to its high prevalence and higher rates of ischemic cardiovascular and lower extremity events, its treatment is essential. Oxidative stress plays a vital role in the development of PAD, but not in isolation, as other risk factors including hypertension, diabetes, smoking, hypercholesterolemia, obesity, and physical inactivity also contribute to the development of symptoms of PAD. However, it has been shown that increased levels of oxidative stress can be an important mechanism in the pathophysiology of these risk factors, leading to increased levels of oxidized LDL (ox-LDL), increased thrombus formation, endothelial dysfunction, and the development of atherosclerotic plaques. Therefore, it can be deduced that antioxidants may be effective in PAD treatment. This review aimed to evaluate different studies of antioxidant treatments for PAD patients. Methodology & Theoretical Orientation: A systematic search for relevant studies was performed on the PubMed, SCOPUS, and Science Direct databases, and 18 studies fulfilled the inclusion criteria. Findings: In total, 16.6% of the studies used natural antioxidants, and 83.3% used synthetic antioxidants. The reviewed studies show that natural antioxidants were completely effective in treating PAD, and synthetic antioxidants showed effective results in only 53% of the studies. A less than optimal pro-oxidant–antioxidant balance does not improve the symptoms of PAD. Conclusion & Significance: In conclusion, though there is optimism regarding using antioxidants in treating PAD, the outcomes do not support the optimism. Using antioxidants in the natural forms and vitamins in the form of fruits and vegetables is likely to be more effective for PAD patients. Finally, two essential factors must be considered to be more effective in treating PAD. First, evaluating the optimal pro-oxidant–antioxidant balance can be an effective method for managing treatment with antioxidants. In other words, prescribing antioxidants at the appropriate dose makes antioxidants more effective and strongly suggests that custom therapies need to be devised. Secondly, using the optimal amount of antioxidants for treating the underlying disease in PAD patients, together with other agents such as anticoagulants, antiplatelet agents, antihypertensive, hypoglycemic agents, antidiabetic agents, statins, and other cholesterol balancing drugs, is a strong recommendation.

Biography:

Shayan Keramat chose the field of the medical laboratory from the undergraduate course from 2012 to 2016. After a short time, He became very interested in hematology and pathology. So He decided to pursue a master's degree in hematology. After entering the Master in 2017, I became interested in the fields of coagulation, thrombosis, vascular diseases and especially thromboangiitis obliterans (TAO). Shayan Keramat started my dissertation with research on TAO and finished it with the highest possible score and two articles. In 2019 I took a commitment course in the biochemistry research laboratory of Mashhad Medical University for two years until 2021.  Currently, He is a major member of the Department of Research and Biobanking, Buerger’s Disease Non-Governmental Organization and an active member of Vascular Independent Research and Education, European Foundation, VAS Young committee.