High prevalence of undiagnosed patients with peripheral arterial disease in patients hospitalised for non-vascular disorders.
BACKGROUND
Several studies highlight the underestimation of peripheral arterial disease (PAD) rates in general population, leading to a lack of opportunity to detect subjects at a high risk for cardiovascular events. We sought to investigate (i) the prevalence of unrecognised PAD in patients hospitalised for non-vascular diseases and (ii) the intensity of preventive drug therapies in this population.


METHODS
This study was of the cross-sectional design in a tertiary care hospital, which included 291 randomly selected patients of >or=40 years of age. Patients were assessed for medical history, pulse palpation and ankle-brachial index (ABI). The Edinburgh Claudication Questionnaire (ECQ) was administered. PAD was defined either by an ABI<or=0.9 or>or=1.4 or in case of limb revascularisation history.


RESULTS
Overall PAD prevalence was 29%; 21 patients (7.2%) with a history of PAD, while 65 (22.3%) had an unknown PAD. Among patients with unknown PAD, a typical intermittent claudication was unusual (3%). In patients without cardiovascular disease (CVD), four factors were associated with unrecognised PAD: absence of posterior tibial pulse (OR 4.49, 95% CI 1.89-10.51; p<0.001), male sex (OR 2.32, 95% CI 1.03-5.25; p=0.04), age>70 years (OR 2.44, 95% CI 1.07-5.58; p=0.04), CVD risk factors>or=2 (OR 2.63, 95% CI 1.20-5.76; p=0.02). Antiplatelet therapy and statins were each prescribed in 35.5% of the unrecognised PAD patients with ABI<or=0.9 and 25.8% of those with ABI>or=1.4.


CONCLUSIONS
In a tertiary care hospital, the prevalence of unrecognised PAD among patients hospitalised for non-PAD-related causes is high and the preventive CVD therapy rates are low. Hospitalisation is a good opportunity to detect PAD.
Lacroix
P
P
Department of Cardiovascular Surgery and Vascular Medicine, Dupuytren University Hospital, Limoges Cedex, France. philippe.lacroix@unilim.fr
Aboyans
V
V
Voronin
D
D
Le Guyader
A
A
Cautrès
M
M
Laskar
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015995:Prevalence
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors