Polyvascular disease, pulse pressure and mortality

Area of Science:

• Cardiology
• Vascular Medicine
• Epidemiology

Background:

• Peripheral arterial disease (PAD), coronary artery disease (CAD), and carotid stenosis (CS) are established mortality predictors.
• The impact of polyvascular disease (PVD) on mortality in patients with atherosclerotic burden requires further clarification.

Purpose of the Study:

• To evaluate the predictive value of PAD, CAD, and CS for mortality in patients at intermediate to high cardiovascular risk.

Main Methods:

• Retrospective observational study using baseline data from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study.
• Analysis of 3316 patients referred for coronary angiography, adjusting for key demographic and clinical factors.

Main Results:

• Increasing numbers of atherosclerotic vascular beds (PAD, CAD, CS) significantly correlated with higher all-cause and cardiovascular mortality.
• PAD combined with CAD or CS showed substantially higher mortality hazard ratios compared to CAD with CS.
• PVD presence was associated with increased age, blood pressure, vascular stiffness, smoking history, and reduced estimated glomerular filtration rate (eGFR).

Conclusions:

• All-cause and cardiovascular mortality rates increase in parallel with the number of affected atherosclerotic vascular beds.
• Simultaneous PAD presence confers a significantly higher mortality risk than CS coexistence.
• Elevated atherosclerotic burden may contribute to vascular stiffness and renal function impairment.