Long-Term Prognosis and Predictive Risk Factors for Polyvascular Disease in Patients with Peripheral Arterial Disease

Pub Date : 2022-01-01 DOI:10.4236/wjcd.2022.121006
K. Nakashima, H. Kumakura, R. Funada, Yae Matsuo, Kimimasa Sakata, Akiko Ichikawa, T. Iwasaki, S. Ichikawa
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Abstract

Background: The aim of the current study was to assess fifteen-year life expectancy, cardiovascular events, fate of the limb, and risk factors with or without polyvascular disease in patients with Peripheral Arterial Disease (PAD). Methods: We conducted a prospective cohort study in 1019 PAD patients. The endpoints were Cardiovascular or Cerebrovascular Death (CCVD), All-Cause Death (ACD), Major Adverse Cardiovascular Events (MACE), and Cardiovascular and/or Limb Events (CVLE). Results: The patients who died were 539 (52.9%) during follow-up periods. The rate of CCVD was 50.5% (n = 272). In multiple regression analysis, the number of affected arteries had correlations with estimated Glomerular Filtration Rate (eGFR), HDL-cholesterol, Ankle Brachial Pressure Index (ABI), and diabetes (p < 0.05). In multiple logistic analysis, PAD with Cerebrovascular Disease (CVD) was cor related with older age, ABI, eGFR, and atrial fibrillation (p < 0.05); to CVLE (p < 0.05). Statins improved all outcomes (p < 0.05). Conclusions: Polyvascular disease was independently associated with fifteen-year mortality, cardiovascular events, and the fate of the limb with diverse risk factors in PAD patients.
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外周动脉疾病患者多血管疾病的长期预后及预测危险因素
背景:本研究的目的是评估外周动脉疾病(PAD)患者的15年预期寿命、心血管事件、肢体命运和伴有或不伴有多血管疾病的危险因素。方法:我们对1019例PAD患者进行了前瞻性队列研究。终点是心脑血管死亡(CCVD)、全因死亡(ACD)、主要不良心血管事件(MACE)和心血管和/或肢体事件(CVLE)。结果:随访期间死亡539例(52.9%)。CCVD发生率为50.5% (n = 272)。在多元回归分析中,受影响动脉数量与肾小球滤过率(Glomerular Filtration Rate, eGFR)、高密度脂蛋白胆固醇(HDL-cholesterol)、踝肱压指数(Ankle Brachial Pressure Index, ABI)和糖尿病相关(p < 0.05)。多因素logistic分析显示,PAD合并脑血管病(CVD)与年龄、ABI、eGFR、房颤相关(p < 0.05);与CVLE比较(p < 0.05)。他汀类药物改善了所有结果(p < 0.05)。结论:多血管疾病与PAD患者15年死亡率、心血管事件和具有多种危险因素的肢体命运独立相关。
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