Prevalence and prognostic influence of peripheral arterial disease in patients >or=40 years old admitted into hospital following an acute coronary event.
OBJECTIVE
A significant proportion of patients with ischemic heart disease have associated peripheral arterial disease (PAD), but many are asymptomatic and this condition remains underdiagnosed. We aimed to study the prevalence of PAD in patients with an acute coronary syndrome (ACS) and to evaluate its influence in hospital clinical outcomes.


METHODS
The PAMISCA register is a prospective, multicenter study involving patients >or=40 years old with ACS admitted to selected Spanish hospitals. All patients had their ankle-brachial index (ABI) measured between days 3 and 7 after the ischemic event.


RESULTS
1410 ACS patients (71.4% male) were included. PAD determined by ABI was documented in 561 patients (39.8%). Factors independently related to PAD were age (OR: 1.04; 95% CI: 1.03-1.06; p<0.001), smoking (OR: 1.88; 95% CI: 1.41-2.49; p<0.0001), diabetes (OR: 1.30; 95% CI: 1.02-1.65; p<0.05), previous cardiac disease (OR: 1.54; 95% CI: 1.22-1.95; p<0.001) and previous cerebrovascular disease (OR: 1.90; 95% CI: 1.28-2.80; p<0.001). Following the ACS, an ABI<or=0.90 was associated with increased cardiovascular mortality (OR: 5.45; 95% CI: 1.16-25.59; p<0.05) and a higher risk of cardiovascular complications.


CONCLUSIONS
The prevalence of PAD in patients >or=40 years presenting with ACS is high and it is associated with increased cardiovascular risk.
Bertomeu
V
V
Hospital Universitario de San Juan, Alicante, Spain.
Morillas
P
P
Hospital Universitario de San Juan, Alicante, Spain. Electronic address: pedromorillas@teleline.es.
Gonzalez-Juanatey
J R
JR
Hospital Santiago de Compostela, A Coruña, Spain.
Quiles
J
J
Hospital Universitario de San Juan, Alicante, Spain.
Guindo
J
J
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Soria
F
F
Hospital Virgen de la Arrixaca, Murcia, Spain.
Llacer
A
A
Hospital Clínico Universitario, Valencia, Spain.
Lekuona
I
I
Hospital de Galdakao, Vizcaya, Spain.
Mazón
P
P
Hospital Santiago de Compostela, A Coruña, Spain.
Martín-Luengo
C
C
Hospital Universitario de Salamanca, Salamanca, Spain.
Rodriguez-Padial
L
L
Hospital Virgen de la Salud, Toledo, Spain.
D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013997:Time Factors