Profile of Cardiovascular Risk Factors and Mortality in Patients with Symptomatic Peripheral Arterial Disease

Abstract

INTRODUCTION: The present study examines cardiovascular risk factor profiles and 24-month mortality in patients with symptomatic peripheral arterial disease. DESIGN STUDY: Prospective observational study including 75 consecutive patients with PAD (67 ± 9.7 years of age; 52 men and 23 women) hospitalized for planned peripheral vascular reconstruction. Doppler echocardiograms were performed before surgery in 54 cases. Univariate analyses were performed using Student's t-test or Fisher's exact test. Survival analysis at 24-month follow-up was performed using the Cox regression model and Kaplan-Meier method including age and chronic use of aspirin as covariates. Survival curves were compared using the log-rank test. RESULTS: Hypertension and smoking were the most frequent risk factors (52 cases and 51 cases, respectively), followed by diabetes (32 cases). Undertreated dyslipidemia was found in 26 cases. Fasting glycine levels (131 ± 69.1 mg/dl) were elevated in 29 cases. Myocardial hypertrophy was found in 18 out of 54 patients. Thirty-four patients had been treated with aspirin. Overall mortality over 24 months was 24% and was associated with age (HR: 0.064; CI95: 0.014-0.115; p=0.013) and lack of use of aspirin, as no deaths occurred among those using this drug (p<0.001). No association was found between cardiovascular death (11 cases) and the other risk factors. CONCLUSION: There is a high prevalence of uncontrolled (treated or untreated) cardiovascular risk factors in patients undergoing planned peripheral vascular reconstruction, and chronic use of aspirin is associated with reduced all-cause mortality in these patients

Detecting Peripheral Arterial Disease in Primary Care: A Population Based Study

“…5,14) Although a strong relationship between DM and low ABI was found in many studies, the association between DM and low ABI lost its significance after conducting multivariate adjustments in the Framingham Heart Study. 1,2,14) This association was not revealed in our study too. This may be due to the good blood glucose control among the diabetic participants.…”

“…If it is left untreated, it can increase the risk of heart attack, stroke, amputation, and death. 2) Moreover, the clinical symptoms of PAD such as intermittent claudication, arterial ulcers, necrosis, and gangrene can greatly reduce patients' quality of life. 3) Several diseases and conditions, including advanced age, smoking, diabetes, hypertension, hyperlipidemia, male sex, and elevated blood glucose, are considered as risk factors of PAD.…”

“…3) Several diseases and conditions, including advanced age, smoking, diabetes, hypertension, hyperlipidemia, male sex, and elevated blood glucose, are considered as risk factors of PAD. 2) A low ankle-brachial index (ABI) level is an important indicator of atherosclerosis, but only 20% of the patients who have ABI level <0.90 develop symptoms. 3) Therefore, PAD is currently considered as a subclinical disease, which can progress silently.…”

Association of borderline ankle-brachial index with mortality and the incidence of peripheral artery disease in diabetic patients

“…Peripheral arterial disease (PAD) has been widely accepted as a significant risk factor for all-cause death or cardiovascular death [1e9]. Diabetes is also regarded as a significant risk factor for death [10,11], and PAD is more frequent in diabetic patients than in nondiabetic patients [12e15]. Ankle-brachial index (ABI) is used to diagnose PAD with simplicity, inexpensiveness, and high specificity [16].…”

Utilização de ácido acetilsalicílico (AAS) na prevenção de doenças cardiovasculares: um estudo de base populacional

“…No Brasil, existem poucos estudos para avaliar o uso de AAS, mas eles têm sido realizados em nível hospitalar ou ambulatorial, com frequências de uso de AAS de 17,7% no caso da prevenção primária e até 98% na prevenção secundária 10,11,12,13,14 . No entanto, não foram localizados estudos brasileiros de base populacional que tenham avaliado o uso de AAS para a prevenção primária ou secundária das DCV e nem os fatores que poderiam estar associados ao seu uso.…”