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

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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