Incidence of new cardiovascular events in patients with and without peripheral arterial disease seen in a vascular surgery clinic
Amit Chhabra, Wilbert S. Aronow, Chul Ahn, Kurt Duncan, Jay D. Patel, Alexander I. Papolos, Babu Sateesh
Med Sci Monit 2012; 18(3): CR131-134
Background: To investigate the incidence of death and of new cardiovascular events at long-term follow-up of patients with and without PAD seen in a vascular surgery clinic.
Material/Methods: We investigated the incidence of death, new stroke/transient ischemic attack, new myocardial infarction, new coronary revascularization, new carotid endarterectomy, new peripheral arterial disease (PAD) revascularization, or at least one of the above outcomes at long-term follow-up of patients with and without PAD followed in a vascular surgery clinic.
Results: At least one of the above outcomes occurred in 259 of 414 patients (63%) with PAD at 33-month follow-up and in 21 of 89 patients (24%) without PAD at 48-month follow-up (p<0.0001). Death occurred in 112 of 414 patients (27%) with PAD and in 10 of 89 patients (11%) without PAD (p=0.002). Stepwise Cox regression analysis for the time to at least one of the 6 outcomes showed that significant independent risk factors were men (hazard ratio =1.394; 95% CI, 1.072–1.813; p=0.013), estimated glomerular filtration rate (hazard ratio =0.992; 95% CI, 0.987–0.997; p=0.003), and PAD (hazard ratio =3.520; 95% CI, 2.196–5.641; p<0.0001). Stepwise Cox regression analysis for the time to death showed that significant independent risk factors were age (hazard ratio =1.024; 95% CI, 1.000–1.049; p=0.048), estimated glomerular filtration rate (hazard ratio =0.985; 95% CI, 0.974–0.996; p=0.007), and PAD (hazard ratio =2.157; 95% CI, 1.118–4.160; p=0.022).
Conclusions: Patients with PAD have a significantly higher incidence of cardiovascular outcomes, especially death, new PAD revascularization, and new carotid endarterectomy, than patients without PAD followed in a vascular surgery clinic.
Keywords: Male, Middle Aged, Incidence, Humans, Female, Case-Control Studies, Cardiovascular Diseases - complications, Aged, 80 and over, Aged, Peripheral Arterial Disease - complications, Risk Factors