title: Long-term cardiovascular outcomes following ischemic heart disease in patients with and without peripheral vascular disease.
abstract: BACKGROUND
  Peripheral vascular disease (PVD) is associated with an increased risk of cardiovascular disease. However, few studies have evaluated the prognosis of asymptomatic PVD in patients with coronary artery disease (CAD).
  
  
  METHODS
  The aim of the study was to determine the prevalence of asymptomatic and symptomatic PVD in patients with ST-elevated myocardial infarction (STEMI) or unstable angina pectoris (UAP) who underwent percutaneous coronary intervention (PCI), and to conduct a 3-year follow-up for cardiovascular events. Systemic atherosclerosis was evaluated, using duplex ultrasonography in 380 consecutive patients who had undergone PCI from January 2003 to December 2005.
  
  
  RESULTS
  Twenty-four percent of the CAD patients had PVD. Patients with PVD had significantly more risk factors for atherosclerosis, including increased age, diabetes mellitus, smoking (p < 0.05), and multivessel CAD (p < 0.001). Multivariate regression analysis demonstrated that STEMI, PVD and multivessel CAD were independent predictors for major adverse cardiac events (MACE) (p < 0.05). Kaplan-Meier curves for MACE in all the patients showed that the MACE rates were significantly higher in STEMI and PVD cases compared with other cases (p < 0.05). We also classified patients with PVD into symptomatic (53%) and asymptomatic (47%) cases, and the MACE rates between these groups did not differ significantly (p < 0.82).
  
  
  CONCLUSIONS
  There is a high prevalence of asymptomatic PVD in patients with CAD and even asymptomatic PVD is associated with increased CAD mortality.
authors.affiliation: Department of Internal Medicine and Cardiology, Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakata
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yokoi
authors.forename: Ryo
authors.initials: R
authors.lastname: Matsumoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shirai
authors.forename: Ryo
authors.initials: R
authors.lastname: Otsuka
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugioka
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yoshitani
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ehara
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000628:therapy*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis