title: Contribution of cardiovascular risk factors to coronary risk in patients with intermittent claudication in the PRIME Cohort Study of European men.
abstract: BACKGROUND
  Intermittent claudication (IC) is associated with an increased cardiovascular morbidity. The goal of the present study was to assess the contribution of conventional cardiovascular risk factors (CVRFs) to this increased risk.
  
  
  METHODS
  The PRIME Study is a multicenter Prospective Cohort Study of 10 602 men recruited in 1991-1993, aged 50-59 at baseline and followed over 10 years. At baseline, a questionnaire on socio demographic data was self-administered and CVRFs were measured. Composite outcome consisted of incident MI, effort angina, unstable angina and coronary death. The standardized questionnaire of the London School of hygiene was used to identify claudicants. Data were analyzed using multivariate Cox models.
  
  
  RESULTS
  Probable and possible cases of IC were reported by 1.4% (135) and 4.6% (442) of subjects, respectively. Compared to subjects with no claudication, the probable cases demonstrated higher rates of CVRFs. The incidence of CAD events was 7.23/1000 person-year. Compared to non claudicants, probable claudicants had an increased age and country adjusted risk of coronary events (HR (95% CI), 2.4 (1.5-3.7), p<0.0001). After further adjustments for school duration, family history of early myocardial infarction, tobacco consumption, alcohol consumption, BMI, systolic blood pressure, antihypertensive treatment, diabetes, total cholesterol, HDL-cholesterol, triglycerides and lipid-lowering treatment, participants with probable claudication had an increased risk of coronary events but this was no longer significant (HR (95% CI), 1.3 (0.8-2.1), p=0.23).
  
  
  CONCLUSIONS
  IC is associated with an increased risk of developing coronary events. This association is largely explained by the coexistence of CVRFs.
authors.affiliation: Institut Pasteur de Lille, INSERM U744, Université de Lille 2, Lille, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Tilloy
authors.forename: Michèle
authors.initials: M
authors.lastname: Montaye
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
authors.forename: Annie
authors.initials: A
authors.lastname: Bingham
authors.forename: Dominique
authors.initials: D
authors.lastname: Arveiler
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Ruidavets
authors.forename: Alun
authors.initials: A
authors.lastname: Evans
authors.forename: Bernadette
authors.initials: B
authors.lastname: Haas
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
authors.forename: Pierre
authors.initials: P
authors.lastname: Ducimetière
authors.forename: Philippe
authors.initials: P
authors.lastname: Amouyel
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
mesh_terms: D000789:Angina, Unstable; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007383:Intermittent Claudication / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D009660:Northern Ireland / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects