Profile of cardiovascular risk factors and mortality in patients with symptomatic peripheral arterial disease.
BACKGROUND
The present study examines cardiovascular risk factor profiles and 24-month mortality in patients with symptomatic peripheral arterial disease.


METHODS
Prospective observational study including 75 consecutive patients with PAD (67 +/- 9.7 years of age; 52 men and 23 women) hospitalized for planned peripheral vascular reconstruction. Doppler echocardiograms were performed before surgery in 54 cases. Univariate analyses were performed using Student's t-test or Fisher's exact test. Survival analysis at 24-month follow-up was performed using the Cox regression model and Kaplan-Meier method including age and chronic use of aspirin as covariates. Survival curves were compared using the log-rank test.


RESULTS
Hypertension and smoking were the most frequent risk factors (52 cases and 51 cases, respectively), followed by diabetes (32 cases). Undertreated dyslipidemia was found in 26 cases. Fasting glycine levels (131 +/- 69.1 mg/dl) were elevated in 29 cases. Myocardial hypertrophy was found in 18 out of 54 patients. Thirty-four patients had been treated with aspirin. Overall mortality over 24 months was 24% and was associated with age (HR: 0.064; CI95: 0.014-0.115; p=0.013) and lack of use of aspirin, as no deaths occurred among those using this drug (p<0.001). No association was found between cardiovascular death (11 cases) and the other risk factors.


CONCLUSIONS
There is a high prevalence of uncontrolled (treated or untreated) cardiovascular risk factors in patients undergoing planned peripheral vascular reconstruction, and chronic use of aspirin is associated with reduced all-cause mortality in these patients.
Zanati
Silméia Garcia
SG
Department of Internal Medicine, Botucatu Medical School, Botucatu, SP, Brazil. sgzanati@fmb.unesp.br
Mouraria
Guilherme Grisi
GG
Matsubara
Luiz Shigero
LS
Giannini
Mariângela
M
Matsubara
Beatriz B
BB
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D016491:Peripheral Vascular Diseases / Q000401:mortality*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016019:Survival Analysis
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin