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Ten Year Mortality in Different Peripheral Arterial Disease Stages: A Population Based Observational Study on Outcome
Karolinska Inst, Sweden.
Uppsala Univ, Sweden.
Cty Council Varmland, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
2018 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 55, no 4, p. 529-536Article in journal (Refereed) Published
Abstract [en]

Objective: The aim was to determine long-term mortality rates and the underlying cause of death for subjects with different peripheral arterial disease (PAD) stages in a population based setting. Methods: A randomly selected population sample of 5080 subjects was enrolled in the study in 2004-2005. Participants completed health state questionnaires and underwent ankle brachial index (ABI) measurements for classification into PAD severity stages and reference subjects. A follow-up was conducted by the end of 2015 using data from Swedish governmental national registers for cause of death, which was then compared with PAD stage determined at baseline in 2005. Results: The 10 year all cause mortality was 27% for reference cases, 56% for asymptomatic PAD (APAD), 63% for intermittent claudication (IC), and 75% for severe limb ischaemia (SLI). Among all PAD subjects, cardiovascular (CV) causes were the most common main cause of death (45%) and a CV event was present as either the main or one of the three most common contributing causes of death in 64% of the cases. The age adjusted hazard ratios for a main cause of death by a CV event were 1.9 (95% CI 1.5-2.3) for APAD, 2.6 (95% CI 2.1-3.4) for IC, and 3.5 (95% CI 2.3-5.2) for SLI. Conclusion: PAD subjects, including the APAD subjects, are still at high risk of CV death. The mortality risks are more than doubled in symptomatic PAD patients compared with reference subjects and increase by severity of PAD stage. Awareness and improved risk reduction management of PAD are still warranted. (C) 2018 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
W B SAUNDERS CO LTD , 2018. Vol. 55, no 4, p. 529-536
Keywords [en]
Peripheral arterial disease; Mortality; Cardiovascular death
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-148262DOI: 10.1016/j.ejvs.2018.01.019ISI: 000432456100019PubMedID: 29478910OAI: oai:DiVA.org:liu-148262DiVA, id: diva2:1213351
Note

Funding Agencies|Swedish Heart-Lung Foundation; Varmlands County Research Council; Sanofi-Aventis

Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2018-06-04

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Wahlberg, Eric
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular Surgery
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