In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 139, No. Suppl_1 ( 2019-03-05)
Abstract:
Background: The FOURIER trial of a PCSK9 inhibitor in patients with prevalent cardiovascular disease reported that patients with peripheral artery disease (PAD) without myocardial infarction (MI) or stroke (MI/stroke) had worse prognosis than those with MI/stroke without PAD. However, whether this observation holds in the general population is unknown. Methods: We conducted a prospective analysis of 5,858 participants aged 40 years or older from the 1999-2004 National Health and Nutrition Examination Survey and compared overall mortality among four categories by PAD (ankle-brachial index ≤0.9) and MI/stroke (self-report) status at baseline using Kaplan-Meier curves and multivariable Cox models adjusted for potential confounders such as age, sex, race, diabetes, smoking, blood pressure, and lipids. Results: There were 125 participants (2.1%) with both PAD and MI/stroke, 323 (5.5%) with PAD without MI/stroke, and 571 (9.7%) with MI/stroke without PAD (4,785 participants without MI/stroke or PAD). During a median follow-up of 9.5 years, 1,133 participants died. Compared to those without PAD or MI/stroke, participants with both MI/stroke and PAD had the worst survival (36.8% at 10 years), followed by those with PAD without MI/stroke (56.4%) and then those with MI/stroke without PAD (71.0%) (Figure). Multivariable Cox models showed similar patterns: adjusted hazard ratios of 2.81 [95% CI 2.16-3.66] in MI/stroke with PAD, 1.85 (1.41-2.43) in PAD without MI/stroke, and 1.59 [1.30-1.95] in MI/stroke without PAD. Conclusions: In the general population, the presence of PAD contributed to significantly higher mortality in those with and without MI/stroke. PAD without MI/stroke showed similar or even worse prognosis than MI/stroke without PAD. These results suggest the importance of recognizing the presence of PAD in the community.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.139.suppl_1.009
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
1466401-X
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