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Outcomes and risk prediction model for peripheral arterial disease in patients with stable coronary artery disease

Apurva O Badheka1, Ankit D Rathod, Aditya S Bharadwaj

  • 1Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA.

Angiology
|July 27, 2011
PubMed

Insights

This study identified key risk factors for critical peripheral arterial disease (PAD) in patients with coronary artery disease (CAD). A developed risk score may help identify individuals needing interventions like angioplasty or bypass grafting.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Clinical Epidemiology

Background:

  • Stable coronary artery disease (CAD) patients with preserved ejection fraction are a significant population.
  • Peripheral arterial disease (PAD) is a serious complication requiring interventions such as angioplasty or bypass grafting.
  • Identifying risk factors for critical PAD is crucial for proactive patient management.

Purpose of the Study:

  • To identify risk factors for the development of critical peripheral arterial disease (PAD) in patients with stable coronary artery disease (CAD).
  • To formulate a risk score for predicting critical PAD events in this population.
  • To assess the association between critical PAD and adverse cardiovascular outcomes.

Main Methods:

  • Utilized the National Heart, Lung, and Blood Institute Prevention of Events with Angiotensin-Converting Enzyme Inhibition (PEACE) Trial dataset (n=8290).
  • Employed multivariate analyses to identify significant predictors of critical PAD.
  • Calculated a risk score based on identified risk factors.

Main Results:

  • A total of 220 patients (2.8%) developed critical PAD over a mean follow-up of 4.7 years.
  • Significant predictors included intermittent claudication, smoking, hypertension (HTN), coronary-artery bypass grafting (CABG), diabetes, age, serum cholesterol, and body mass index (BMI).
  • Incident critical PAD was associated with an increased composite outcome of cardiovascular death, myocardial infarction, or revascularization (HR 1.82).

Conclusions:

  • Several modifiable and non-modifiable factors predict critical PAD in CAD patients.
  • The developed risk score may aid in identifying CAD patients at high risk for critical PAD.
  • Early identification and intervention can potentially mitigate severe PAD events and associated cardiovascular outcomes.

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