Author(s): Grenon SM, Vittinghoff E, Owens CD, Conte MS, Whooley M, et al.
Among patients with coronary artery disease (CAD), those with peripheral artery disease (PAD) have a greater vulnerability to cardiovascular (CV) events than those with CAD alone. In a prospective cohort study of patients with CAD, we evaluated potential mechanisms that might explain the adverse CV outcomes associated with PAD. We performed a prospective cohort study of 1018 patients with stable CAD who were recruited from 2000 to 2002. Incident symptomatic PAD events were adjudicated during a follow-up period of 7.2 ± 2.6 years. We used Cox proportional hazards models to evaluate the association between incident symptomatic PAD events and subsequent risk of CV events or death. Models were adjusted for demographics, traditional risk factors, inflammation, insulin resistance and health behaviors. Among the 1018 patients, 50 patients who did not report a history of PAD at baseline suffered incident symptomatic PAD events during the follow-up period. Those patients had a higher risk of subsequent CV events and death compared to those who did not develop PAD. After adjustment for traditional risk factors, symptomatic PAD events remained associated with a 70% increased risk of subsequent CV events (adjusted HR 1.7; 95% CI 1.0, 2.9; p = 0.04) and an 80% increased risk of death (adjusted HR 1.8; 95% CI 1.2, 2.7; p = 0.006). Inflammatory biomarkers were the strongest risk factor contributing to the excess risk. In a contemporary cohort of patients with CAD, incident symptomatic PAD events were associated with an increased risk for subsequent CV events. The increased vulnerability to CV events was partially explained by shared CV risk factors and inflammation.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/23835937
Author(s): Criqui MH, Aboyans V
Author(s): Criqui MH, Langer RD, Fronek A, Feigelson HS, Klauber MR, et al.
Author(s): McDermott MM, Liu K, Greenland P, Guralnik JM, Criqui MH, et al.
Author(s): Newman AB, Haggerty CL, Kritchevsky SB, Nevitt MC, Simonsick EM
Author(s): de Liefde II, Hoeks SE, van Gestel YR, Klein J, Bax JJ, et al.
Author(s): Feringa HH, Bax JJ, van Waning VH, Boersma E, Elhendy A, et al.
Author(s): Lee JY, Lee SW, Lee WS, Han S, Park YK, et al.
Author(s): Del Brutto OH, Sedler MJ, Mera RM, Lama J, Gruen JA, et al.
Author(s): Gronewold J, Hermann DM, Lehmann N, Kröger K, Lauterbach K, et al.
Author(s): Garg PK, Tian L, Criqui MH, Liu K, Ferrucci L, et al.
Author(s): Gardner AW, Montgomery PS, Parker DE
Author(s): Bartelink ML, Stoffers HE, Biesheuvel CJ, Hoes AW
Author(s): Fokkenrood HJ, Bendermacher BL, Lauret GJ, Willigendael EM, Prins MH, et al.
Author(s): Kruidenier LM, Nicolaï SP, Rouwet EV, Peters RJ, Prins MH, et al.
Author(s): Vemulapalli S, Dolor RJ, Hasselblad V, Schmit K, Banks A, et al.
Author(s): Kruidenier LM, Nicolaï SP, Hendriks EJ, Bollen EC, Prins MH, et al.
Author(s): Bendermacher BL, Willigendael EM, Nicolaï SP, Kruidenier LM, Welten RJ, et al.
Author(s): Mika P, Spodaryk K, Cencora A, Unnithan VB, Mika A
Author(s): Bulmer AC, Coombes JS