Effect of nitrate administration on peak systolic velocity in peripheral arterial disease patients at Sardjito General Hospital in Yogyakarta

Background: The global prevalence of peripheral artery disease (PAD) in 2010 was more than 200 million people, with an estimated 54.8 million of those found in southeast Asia. Disability-adjusted life years (DALYs) in 2014 were reported higher in developing countries than in developed ones. Moreover, the wide spectrum of manifestations from asymptomatic to limb threatening PAD posed unique challenges to clinicians and researchers. Nitric oxide, a signaling molecule involved in endothelial function, is known to have correlation with symptoms in PAD patients. However, little is known about the role of nitrate or nitric oxide administration to improve symptomatic PAD patients. Therefore, the purpose of this study is to observe the effect of nitrate administration on peak systolic velocity (PSV) ratios in PAD patients. Methods: We conducted a pre-post experimental analytic study. The subjects of this study were patients with PAD at Dr. Sardjito Hospital in Yogyakarta, Indonesia, who were registered in our hospital vascular registry. The primary endpoint was the change in PSV ratio after short-term administration of oral nitroglycerin, given 2.5 mg once daily (4 hours) and long term (7 days). Results: Primary outcome data was available for 33 patients. Nitrate exposure resulted in an improvement in PSV ratios, both for short-term and long-term exposure (ie, a decrease of 0.239 and 0.5, respectively), although only long-term exposure was shown to have evidence in this study (P: 0.163; P: 0.002, respectively). Conclusion: Long-term use of oral nitrate or nitroglycerin improves PSV ratios in PAD patients. Findings in this study provide additional support for use of nitrate as a therapeutic strategy against worsening symptoms in larger cohorts. © 2022 Elsevier B.V., All rights reserved.