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Cardiovascular long-term outcome and prophylactic treatment patterns in peripheral arterial disease in a population-based cohort
Karolinska Inst, 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.
Uppsala Univ, Sweden.
2019 (English)In: European Heart Journal - Quality of Care and Clinical Outcomes, ISSN 2058-5225, E-ISSN 2058-1742, Vol. 5, no 4, p. 310-320Article in journal (Refereed) Published
Abstract [en]

Aims

This study evaluates 10-year follow-up data on associated comorbidity, mortality, and pharmacological treatment patterns for men and women with different stages of peripheral arterial disease (PAD) in a population-based setting.

Methods and results

This was a prospective observational population-based cohort study, based on physical examinations and questionnaires at baseline supplemented with national register data between 2005 and 2015. Subjects were placed in subgroups defined by ankle–brachial index levels and reported symptoms; asymptomatic PAD (APAD), intermittent claudication (IC), severe limb ischaemia (SLI), or references (Ref). Cox proportional hazards regression models were used for analysis with adjustments for sex and baseline age and comorbidity. The cohort consisted of 5080 subjects (45% males). At baseline, APAD, IC, and SLI were prevalent in 559 (11%), 320 (6.3%), and 78 (1.5%) subjects, respectively. A significant increased risk for cardiovascular (CV) death, even when adjusted for age and baseline morbidity, were noted in all PAD stages as compared with reference group with a small difference between APAD and IC, an adjusted hazard ratio 1.80 (confidence interval 1.45–2.22) and 1.95 (1.50–2.53), respectively. Only about 60% of PAD subjects received medical prophylactic treatment as recommended in guidelines.

Conclusion

Peripheral arterial disease subjects had significantly increased CV morbidity and mortality risks, especially males. Asymptomatic PAD subjects confer similar risk for CV events as symptomatic patients. Our findings motivate enhanced preventive efforts of all PAD stages, including in asymptomatic disease.

Place, publisher, year, edition, pages
Oxford University Press, 2019. Vol. 5, no 4, p. 310-320
Keywords [en]
Peripheral; Arterial; Disease; Cardiovascular; Mortality; Risk
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-164429DOI: 10.1093/ehjqcco/qcz037ISI: 000511410900007PubMedID: 31304962Scopus ID: 2-s2.0-85072904221OAI: oai:DiVA.org:liu-164429DiVA, id: diva2:1416461
Note

Funding Agencies|Swedish Heart-Lung FoundationSwedish Heart-Lung Foundation; Varmlands County Research Council; Sanofi-Aventis(R)

Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2020-03-31Bibliographically approved

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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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