Satinder Singh

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Journals/Publications

• Armstrong, E. J., Chen, D. C., Westin, G. G., Singh, S., McCoach, C. E., Bang, H., Yeo, K. K., Anderson, D., Amsterdam, E. A., & Laird, J. R. (2014). Adherence to guideline-recommended therapy is associated with decreased major adverse cardiovascular events and major adverse limb events among patients with peripheral arterial disease. Journal of the American Heart Association, 3(2), e000697.
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  Current guidelines recommend that patients with peripheral arterial disease (PAD) cease smoking and be treated with aspirin, statin medications, and angiotensin-converting enzyme (ACE) inhibitors. The combined effects of multiple guideline-recommended therapies in patients with symptomatic PAD have not been well characterized.
• Armstrong, E. J., Saeed, H., Alvandi, B., Singh, S., Singh, G. D., Yeo, K. K., Anderson, D., Westin, G. G., Dawson, D. L., Pevec, W. C., & Laird, J. R. (2014). Nitinol self-expanding stents vs. balloon angioplasty for very long femoropopliteal lesions. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 21(1), 34-43.
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  To compare the patency rates and clinical outcomes of balloon angioplasty vs. nitinol stent placement for patients with short (≤150 mm) as compared to long (>150 mm) femoropopliteal (FP) occlusive lesions.
• Nesbitt, T., Doctorvaladan, S., Southard, J. A., Singh, S., Fekete, A., Marie, K., Moser, D. K., Pelter, M. M., Robinson, S., Wilson, M. D., Cooper, L., & Dracup, K. (2014). Correlates of quality of life in rural patients with heart failure. Circulation. Heart failure, 7(6), 882-7.
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  There is abundant research indicating poor physical, psychological, and social functioning of patients with chronic heart failure (HF), a reality that can lead to poor health-related quality of life (QoL). Little is known about the experience of rural patients with HF.
• Singh, G. D., Armstrong, E. J., Yeo, K. K., Singh, S., Westin, G. G., Pevec, W. C., Dawson, D. L., & Laird, J. R. (2014). Endovascular recanalization of infrapopliteal occlusions in patients with critical limb ischemia. Journal of vascular surgery, 59(5), 1300-7.
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  Endovascular therapies are increasingly used for treatment of critical limb ischemia (CLI). Infrapopliteal (IP) occlusions are common in CLI, and successful limb salvage may require restoration of arterial flow in the distribution of a chronically occluded vessel. We sought to describe the procedural characteristics and outcomes of patients with IP occlusions who underwent endovascular intervention for treatment of CLI.
• Singh, S., Armstrong, E. J., Sherif, W., Alvandi, B., Westin, G. G., Singh, G. D., Amsterdam, E. A., & Laird, J. R. (2014). Association of elevated fasting glucose with lower patency and increased major adverse limb events among patients with diabetes undergoing infrapopliteal balloon angioplasty. Vascular medicine (London, England), 19(4), 307-314.
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  Diabetes mellitus (DM) is a significant risk factor for loss of patency after endovascular intervention, but the contribution of glycemic control to infrapopliteal artery patency among patients with DM is unknown. All percutaneous infrapopliteal interventions among patients with DM from 2006 to 2013 were reviewed and pre-procedure fasting blood glucose (FBG) was recorded. The primary endpoint was primary patency at 1 year as determined by duplex ultrasound. A total of 309 infrapopliteal lesions in 149 patients with DM were treated with balloon angioplasty during the study period. The median FBG was 144 mg/dL. At 1 year, the rate of primary patency was 16% for patients with FBG above the median, compared to 46% for patients with FBG below the median (hazard ratio (HR) 1.82 for FBG ≥144, p=0.005). Amputation rates at 1 year trended higher among patients with high versus low FBG (24% vs 15%, p=0.1). One year major adverse limb event rates were also higher for patients with high versus low FBG (35% vs 23%, p=0.05). Although patients with high FBG were more likely to have insulin-requiring DM (73% vs 50%, p=0.003) the association of high FBG with loss of primary patency remained significant even after adjusting for insulin use as well as other lesion-specific characteristics (adjusted HR 1.8, 95% CI 1.2-2.8). In conclusion, high fasting blood glucose at the time of infrapopliteal balloon angioplasty is associated with significantly decreased primary patency and may also be a risk factor for major adverse limb events among patients with a threatened limb.
• Armstrong, E. J., Singh, S., Singh, G. D., Yeo, K. K., Ludder, S., Westin, G., Anderson, D., Dawson, D. L., Pevec, W. C., & Laird, J. R. (2013). Angiographic characteristics of femoropopliteal in-stent restenosis: association with long-term outcomes after endovascular intervention. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 82(7), 1168-74.
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  The purpose of this study was to identify the relationship between angiographic patterns of restenosis and outcomes after endovascular treatment of femoro-popliteal in-stent restenosis (FP-ISR).
• Javed, U., Balwanz, C. R., Armstrong, E. J., Yeo, K. K., Singh, G. D., Singh, S., Anderson, D., Westin, G. G., Pevec, W. C., & Laird, J. R. (2013). Mid-term outcomes following endovascular re-intervention for iliac artery in-stent restenosis. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 82(7), 1176-84.
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  We sought to evaluate the procedural characteristics and clinical outcomes of endovascular repair for iliac artery (IA) in-stent restenosis (ISR).
• McCoach, C. E., Armstrong, E. J., Singh, S., Javed, U., Anderson, D., Yeo, K. K., Westin, G. G., Hedayati, N., Amsterdam, E. A., & Laird, J. R. (2013). Gender-related variation in the clinical presentation and outcomes of critical limb ischemia. Vascular medicine (London, England), 18(1), 19-26.
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  Critical limb ischemia (CLI) is a major cause of limb loss and mortality among patients with advanced peripheral artery disease. Our objective was to evaluate the gender-specific differences in patient characteristics and clinical outcomes among patients with CLI. We performed a retrospective analysis of 97 women and 122 men presenting with CLI who underwent angiography from 2006 to 2010. Baseline demographics, procedural details, and lesion characteristics were assessed for each patient. Kaplan-Meier analysis was used to assess long-term patient and lesion-level outcomes. Cox proportional hazard modeling was used to evaluate the relationship between gender and major adverse cardiovascular events (MACE). Compared to men, women were less likely to have a history of coronary artery disease (39% vs 54%, p = 0.02) or diabetes (57% vs 70%, p = 0.05) but had similar baseline medical therapy. At angiography, women were more likely to have significant femoropopliteal (77% vs 67%, p = 0.02) and multi-level infrainguinal disease (63% vs 51%, p = 0.02). Women were also more likely to undergo multi-vessel percutaneous intervention (69% vs 55%, p = 0.05), but had similar rates of limb salvage after percutaneous intervention or surgical bypass (HR 0.94 [95% CI 0.45-1.94], p = 0.9). During follow-up, women had higher rates of subsequent major adverse cardiovascular events (HR 1.63 [95% CI 1.01-2.63], p = 0.04). In conclusion, women with CLI are more likely to present with femoropopliteal and multi-level infrainguinal disease. Despite similar rates of limb salvage, women with CLI have an increased rate of subsequent major adverse cardiovascular events.