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Risk profiles and long-term mortality in premature and nonpremature peripheral artery disease from two prospective

Xiaoqi Ye1, Yan Li1, Siyu Chen2

  • 1Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Journal of Vascular Surgery
|November 9, 2025
PubMed

Insights

Premature peripheral artery disease (PAD) has unique risk factors and higher long-term mortality, especially from cardiovascular causes, compared to nonpremature PAD. Further research is needed to understand these differences.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Vascular Surgery

Background:

  • Peripheral artery disease (PAD), especially premature PAD, is understudied.
  • Distinct risk profiles and survival outcomes for premature PAD are not well understood.
  • This study compares risk factors and long-term mortality between premature and nonpremature PAD.

Purpose of the Study:

  • To compare risk factors and long-term mortality between premature and nonpremature PAD.
  • To identify distinct characteristics of premature PAD.
  • To assess survival outcomes associated with different PAD subtypes.

Main Methods:

  • Analysis of two large cohorts: UK Biobank (N=348,766) and NHANES (N=6539).
  • Premature PAD defined by sex-specific age cutoffs (men <55, women <65 years).
  • Multinomial logistic regression and Cox proportional hazards models used to assess risk factors and mortality.

Main Results:

  • Premature PAD patients were predominantly female with fewer cardiometabolic comorbidities.
  • Peripheral neuropathy was a significant risk factor for premature PAD but not nonpremature PAD.
  • Adjusted analyses revealed higher all-cause and cardiovascular mortality risks for premature PAD compared to nonpremature PAD.

Conclusions:

  • Premature PAD presents distinct risk profiles.
  • Premature PAD is associated with significantly higher adjusted long-term mortality, particularly from cardiovascular causes.
  • Further research is required to elucidate the mechanisms behind these observed differences.
Abstract

Keywords:
MortalityPeripheral artery diseasePeripheral neuropathyPremature PADProspective cohort study

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