The morbidity and mortality following a diagnosis of peripheral arterial disease: Long term follow-up of a large database

被引:145
作者
Caro J. [1 ,2 ]
Migliaccio-Walle K. [1 ]
Ishak K.J. [3 ]
Proskorovsky I. [3 ]
机构
[1] Caro Research Institute, Concord, MA
[2] Division of General Internal Medicine, McGill University, Montreal, Que.
[3] Caro Research, Montreal, Que.
关键词
Myocardial Infarction; Peripheral Arterial Disease; Reference Population; Transient Ischemic Attack; Index Event;
D O I
10.1186/1471-2261-5-14
中图分类号
学科分类号
摘要
Background: Awareness of the significance of peripheral arterial disease is increasing, but quantitative estimates of the ensuing burden and the impact of other risk factors remains limited. The objective of this study was to fill this need. Methods: Morbidity and mortality were examined in 16,440 index patients diagnosed with peripheral arterial disease in Saskatchewan, Canada between 1985 and 1995. Medical history and patient characteristics were available retrospectively to January 1980 and follow-up was complete to March 1998. Crude and adjusted event rates were calculated and Kaplan-Meier survival curves estimated. Cox proportional hazards analyses were conducted to examine the effect of risk factors on these rates. Patients suffering a myocardial infarction or ischemic stroke in Saskatchewan provided two reference populations. Results: Half of the index patients were male; the majority was over age 65; 73% had at least one additional risk factor at index diagnosis; 10% suffered a subsequent stroke, another 10% a myocardial infarction, and 49% died within the mean follow-up of 5.9 years. Annual mortality (8.2%) was higher among patients with PAD than after a myocardial infarction (6.3%) but slightly lower than that in patients suffering a stroke (11.3%). Index patients with comorbid disease (e.g., diabetes) were at highest risk of death and other events. Conclusions: A diagnosis of peripheral arterial disease is critical evidence of more widespread atherothrombotic disease, with substantial risks of subsequent cardiovascular events and death. Given that the majority has additional comorbidities, these risks are further increased. © 2005 Caro et al., licensee BioMed Central Ltd.
引用
收藏
页数:17
相关论文
共 20 条
[1]  
Stoffers H.E., Rinkens R.P., Kester A.D., Kaiser V., Knottnerus J.A., The prevalence of asymptomatic and unrecognized peripheral arterial occlusive disease, Int. J. Epidemiol., 25, pp. 282-290, (1996)
[2]  
Selvin E., Erlinger T.P., Prevalence and risk factors for peripheral arterial disease in the United States. Results from the National Health and Nutrition Examination Survey, 1999-2000, Circulation, 110, pp. 738-743, (2004)
[3]  
Hirsch A.T., Criqui M.H., Treat-Jacobson D., Regensteiner J.G., Creager M.A., Olin J.W., Krook S.H., Hunninghake D.B., Comerota A.J., Walsh M.E., McDermott M.M., Hiatt W.R., Peripheral arterial disease detection, awareness, and treatment in primary care, JAMA, 286, pp. 1317-1324, (2001)
[4]  
Criqui M.H., Systematic atherosclerosis risk and the mandate for intervention in atherosclerotic peripheral arterial disease, Am. J. Cardiol., 88, SUPPL. 2, pp. 43-47, (2001)
[5]  
Weitz J.I., Byrne J., Clagett P., Farkouh M.E., Porter J.M., Sackett D.L., Strandness D.E., Taylor L.M., Diagnosis and treatment of chronic arterial insufficiency of the lower extremities: A critical review, Circulation, 94, pp. 3026-3049, (1996)
[6]  
Criqui M.H., Peripheral arterial disease - Epidemiological aspects, Vasc. Med., 6, SUPPL. 1, pp. 3-7, (2001)
[7]  
Price P.F., Mowbray P.I., Lee A.J., Rumley A., Lowe G.D., Fowkes F.G., Relationship between smoking and cardiovascular risk factors in the development of peripheral arterial disease and coronary artery disease, Eur. Heart J., 20, pp. 344-353, (1999)
[8]  
McDermott M.M., Greenland P., Liu K., Guralnik J.M., Crique M.H., Dolan N.C., Chan C., Celic L., Pearce W.H., Schneider J.R., Sharma L., Clark E., Gibson D., Martin G.J., Leg symptoms in peripheral arterial disease: Associated clinical characteristics and functional impairment, JAMA, 286, pp. 1599-1606, (2001)
[9]  
Hooi J.D., Stoffers H.E., Kester A.D., Rinkens P.E., Kaiser V., van Ree J.W., Knottnerus J.A., Risk factors and cardiovascular diseases associated with asymptomatic peripheral arterial occlusive disease. The Limburg PAOD Study. Peripheral Arterial Occlusive Disease, Scand. J. Prim. Health Care, 16, pp. 177-182, (1998)
[10]  
Fowkes F., Housley E., Cawood E.H., MacIntyre C.C., Ruckley C.V., Prescott R.J., Edinburgh Artery Study: Prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population, Int. J. Epidemiol., 20, pp. 384-392, (1991)