title: Prevalence and prognostic influence of peripheral arterial disease in patients >or=40 years old admitted into hospital following an acute coronary event.
abstract: 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.
authors: Hospital Universitario de San Juan, Alicante, Spain.
authors: V
authors: V
authors: Bertomeu
authors: Hospital Universitario de San Juan, Alicante, Spain. Electronic address: pedromorillas@teleline.es.
authors: P
authors: P
authors: Morillas
authors: Hospital Santiago de Compostela, A Coruña, Spain.
authors: J R
authors: JR
authors: Gonzalez-Juanatey
authors: Hospital Universitario de San Juan, Alicante, Spain.
authors: J
authors: J
authors: Quiles
authors: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: J
authors: J
authors: Guindo
authors: Hospital Virgen de la Arrixaca, Murcia, Spain.
authors: F
authors: F
authors: Soria
authors: Hospital Clínico Universitario, Valencia, Spain.
authors: A
authors: A
authors: Llacer
authors: Hospital de Galdakao, Vizcaya, Spain.
authors: I
authors: I
authors: Lekuona
authors: Hospital Santiago de Compostela, A Coruña, Spain.
authors: P
authors: P
authors: Mazón
authors: Hospital Universitario de Salamanca, Salamanca, Spain.
authors: C
authors: C
authors: Martín-Luengo
authors: Hospital Virgen de la Salud, Toledo, Spain.
authors: L
authors: L
authors: Rodriguez-Padial
mesh_terms: 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