Long-term cardiovascular outcomes following ischemic heart disease in patients with and without peripheral vascular disease.
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.
Nakata
Shinji
S
Department of Internal Medicine and Cardiology, Osaka City University, Graduate School of Medicine, Japan.
Yokoi
Yoshiaki
Y
Matsumoto
Ryo
R
Shirai
Nobuyuki
N
Otsuka
Ryo
R
Sugioka
Kenichi
K
Yoshitani
Hidetoshi
H
Ehara
Shoichi
S
Kataoka
Toru
T
Yoshiyama
Minoru
M
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