Related Experiment Videos
Coronary disease and stroke in patients with large-vessel peripheral arterial disease
M H Criqui1, R D Langer, A Fronek
1Department of Community and Family Medicine, University of California, San Diego School of Medicine, La Jolla.
Insights
Individuals with large-vessel peripheral arterial disease (LV-PAD) face significantly higher risks for both nonfatal cardiovascular events and mortality. This increased burden affects both men and women, highlighting the systemic impact of LV-PAD.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Epidemiology
Background:
- Large-vessel peripheral arterial disease (LV-PAD) is associated with increased mortality from coronary heart disease (CHD), cardiovascular disease (CVD), and all causes.
- Limited data exists on the risk of nonfatal cardiovascular events (morbidity) in patients with LV-PAD.
Purpose of the Study:
- To evaluate the risk of nonfatal cardiovascular events (morbidity) and mortality in patients with LV-PAD compared to controls.
- To assess differences in CVD morbidity and mortality between men and women with LV-PAD.
Main Methods:
- Population-based study including 67 patients with LV-PAD and 408 control subjects.
- Evaluation of nonfatal CHD, stroke, and total CVD events, morbidity, and mortality over a 10-year follow-up period.
- Logistic regression models adjusted for established CVD risk factors.
Main Results:
- LV-PAD patients exhibited a 3-fold excess of CVD morbidity at baseline compared to controls.
- Women with LV-PAD experienced more nonfatal CVD events during follow-up, leading to comparable overall morbidity rates with men.
- Adjusted logistic regression revealed that LV-PAD increased combined CVD morbidity and mortality 2.5-fold in men and 5-fold in women.
Conclusions:
- The total burden of cardiovascular morbidity and mortality is substantially elevated in both men and women diagnosed with LV-PAD.
- LV-PAD represents a critical indicator of systemic cardiovascular risk, necessitating comprehensive management strategies.
- Gender-specific differences in event patterns exist, but overall risk is significantly heightened across both sexes.
Abstract:
Previous reports have indicated an excess of mortality from coronary heart disease (CHD), cardiovascular disease (CVD), and all causes in subjects with large-vessel peripheral arterial disease (LV-PAD). However, there is little information available concerning the risk of nonfatal events (morbidity) in this patient group. In a population-based study of 67 patients with LV-PAD and 408 control subjects without this condition, nonfatal CHD and stroke, and total CVD events, morbidity and mortality were evaluated in both men and women. Those with LV-PAD had a 3-fold excess of CVD morbidity at baseline compared with control subjects of the same sex. However, the absolute CVD rates were greater in men than women. During the 10 years of follow-up, women with LV-PAD had more nonfatal CVD events than men, resulting in comparable overall morbidity rates. In logistic regression models adjusted for other CVD risk factors, total CVD morbidity and mortality combined with 2.5 times as great in men and 5 times as great in women with LV-PAD as in those without peripheral arterial disease. These results suggest that the total morbidity and mortality burden are dramatically increased in both men and women with LV-PAD.