Abstract
Background: The aim of the current study was to assess fifteen-year life expectancy, cardiovascular events, fate of the limb, and risk factors with or without polyvascular disease in patients with Peripheral Arterial Disease (PAD). Methods: We conducted a prospective cohort study in 1019 PAD patients. The endpoints were Cardiovascular or Cerebrovascular Death (CCVD), All-Cause Death (ACD), Major Adverse Cardiovascular Events (MACE), and Cardiovascular and/or Limb Events (CVLE). Results: The patients who died were 539 (52.9%) during follow-up periods. The rate of CCVD was 50.5% (n = 272). In multiple regression analysis, the number of affected arteries had correlations with estimated Glomerular Filtration Rate (eGFR), HDL-cholesterol, Ankle Brachial Pressure Index (ABI), and diabetes (p cholesterol, and diabetes (p CVD and CHD) was correlated with ABI, eGFR, HDL-cholesterol, and diabetes (p The number of affected arteries had significant correlations with CCVD, ACD, MACE, and CVLE (p 0.05). In Cox multivariate analyses, age, Critical Limb Ischemia (CLI), eGFR, albumin, C-Reactive Protein (CRP), Body Mass Index (BMI), CVD, and CHD were related to CCVD (p Conclusions: Polyvascular disease was independently associated with fifteen-year mortality, cardiovascular events, and the fate of the limb with diverse risk factors in PAD patients.
Highlights
Polyvascular disease is defined as a coexistent arterial disease in two or three territories within each patient [1]
In Cox multivariate analyses, age, Critical Limb Ischemia (CLI), estimated Glomerular Filtration Rate (eGFR), albumin, C-Reactive Protein (CRP), Body Mass Index (BMI), Cerebrovascular Disease (CVD), and Coronary Heart Disease (CHD) were related to Cardiovascular or Cerebrovascular Death (CCVD) (p < 0.05); age, albumin, eGFR, CRP, BMI, CLI, and CVD were associated with All-Cause Death (ACD) (p < 0.05); age, albumin, eGFR, CRP, CLI, CHD, and diabetes were associated with Major Adverse Cardiovascular Events (MACE) (p < 0.05); age, Ankle Brachial Pressure Index (ABI), albumin, eGFR, CRP, CLI, CHD, and diabetes were related
We have found the prevalence of asymptomatic CVD is extremely high and CVD is an independent risk factor for long-term survival and aggravation of limb stages in Peripheral Arterial Disease (PAD) patients [10] [11]
Summary
Polyvascular disease is defined as a coexistent arterial disease in two or three territories (cerebral, coronary, and/or peripheral) within each patient [1]. Patients with Peripheral Arterial Disease (PAD) complicate with severe systemic atherosclerosis that causes mortality due to Cerebrovascular Disease (CVD) and Coronary Heart Disease (CHD) [2] [3] [4] [5]. In addition to the high mortality risk due to CHD and CVD, there is a higher probability of acute limb ischemia, revascularization, and amputation in patients with atherosclerosis of lower limb vessels among PAD patients with polyvascular disease [14]. In Cox multivariate analyses, age, Critical Limb Ischemia (CLI), eGFR, albumin, C-Reactive Protein (CRP), Body Mass Index (BMI), CVD, and CHD were related to CCVD (p < 0.05); age, albumin, eGFR, CRP, BMI, CLI, and CVD were associated with ACD (p < 0.05); age, albumin, eGFR, CRP, CLI, CHD, and diabetes were associated with MACE (p < 0.05); age, ABI, albumin, eGFR, CRP, CLI, CHD, and diabetes were related
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