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The fate of the claudicant--a prospective study of 1969 claudicants
1St George's Hospital, London, U.K.
Insights
This study found that older age, prior heart disease, and low ankle/arm pressure ratio predict mortality in intermittent claudication patients. White blood cell count also predicted cardiovascular events.
Area of Science:
- Vascular Medicine
- Cardiovascular Epidemiology
- Clinical Research
Background:
- Intermittent claudication (IC) is a common manifestation of peripheral artery disease (PAD).
- Understanding predictors of adverse cardiovascular events in IC patients is crucial for risk stratification and management.
Purpose of the Study:
- To identify predictors of serious cardiovascular events and mortality in patients with intermittent claudication.
- To analyze the prognostic value of baseline patient characteristics and laboratory measurements.
Main Methods:
- Prospective study of 1969 patients with intermittent claudication.
- Patients received placebo medication and were monitored for at least 1 year.
- Analysis of entry characteristics and laboratory data for prediction of cardiovascular events.
Main Results:
- Annual mortality rate was 4.3%.
- Significant predictors of total mortality included age, history of coronary heart disease, and ankle/arm pressure ratio < 0.5.
- Initial white cell count was a significant predictor of myocardial infarction, stroke, and vascular deaths.
Conclusions:
- Age, prior coronary heart disease, and low ankle/arm pressure ratio are key predictors of mortality in intermittent claudication.
- White blood cell count may serve as a useful biomarker for predicting major adverse cardiovascular events in this population.
Abstract:
A prospective study of 1969 patients with intermittent claudication receiving placebo medication for a minimum of 1 year is reported. Patients were carefully monitored and only four patients were lost to follow-up. Annual mortality was 4.3%. Thirty-six patients developed a definite myocardial infarction, 27 a major stroke, 32 required a major amputation and 111 required surgical or radiological intervention for deteriorating ischaemia of the leg. The entry characteristics of the patients were analysed as a predictor of serious cardiovascular events. The most sensitive predictors of total mortality were age, history of coronary heart disease and an ankle/arm pressure ratio below 0.5. Of the laboratory measurements performed only the initial white cell count was a significant predictor of myocardial infarction, stroke and vascular deaths.