Diabetes and peripheral arterial disease in men: trends in prevalence, mortality, and effect of concomitant coronary disease.
BACKGROUND
Recent data on trends in diabetes mellitus (DM) prevalence and long-term effect on mortality in peripheral arterial disease (PAD) subjects is lacking.


METHODS
All subjects discharged from any VA medical center between October 1990 to September 1997 with an International Classification of Diseases (ICD)-9 code for PAD and DM in the discharge summary were retrospectively identified. Demographic data were extracted from the database. Mortality data were obtained from the Beneficiary Information and Resource Locator. Outcome measures were age specific DM prevalence over time, and short-term and long-term mortality.


RESULTS
Of 33, 629 patients with PAD, 9474 (29%) had DM. Diabetes mellitus subjects were less likely to be white and had more comorbidities. Mean length of hospital stay was greater for DM (22.3 d vs 18.7 days, P < 0.001). Mortality was higher for DM at 180 days (9.8% vs 8.4%, P < 0.001), 1 year (16.4% vs 13.7%, P < 0.001), and continues to increase at 8 years of follow-up. Logistic regression analysis showed no interaction between DM and coronary artery disease (CAD).


CONCLUSIONS
Diabetes mellitus increases all-cause mortality in subjects with PAD starting at 6 months post-discharge and continues to be higher even at 8 years of follow-up. There was a lack of interaction of DM and CAD on mortality in this cohort of subjects with PAD.
Kamalesh
Masoor
M
Krannert Institute of Cardiology and Richard L. Roudebush VA Medical Center, Indiana University, Indianapolis, Indiana, USA. masoor.kamalesh@med.va.gov
Shen
Jianzhao
J
D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000401:mortality*; D019992:Databases as Topic; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006787:Hospitals, Veterans / Q000639:trends; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000639:trends; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends; D016491:Peripheral Vascular Diseases / Q000401:mortality*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
Diabetes Care. 2004 Aug;27(8):1954-61
15277423
Am Heart J. 2004 Apr;147(4):561-3
15077067
Circulation. 2006 Aug 15;114(7):688-99
16908785
Nat Clin Pract Endocrinol Metab. 2007 Jan;3(1):26-35
17179927
Med Care. 1999 Jun;37(6):529-37
10386565
Circulation. 2004 Jun 1;109(21):2634-42
15173046
Circulation. 2006 Aug 22;114(8):861-6
16923770
J Am Coll Cardiol. 2006 Oct 17;48(8):1567-72
17045889
Diabetes Care. 2003 Dec;26(12):3333-41
14633825
Am J Epidemiol. 1995 Feb 1;141(3):242-50
7840098
N Engl J Med. 1998 Jul 23;339(4):229-34
9673301
Stat Med. 1991 Apr;10(4):541-57
2057654
Int J Epidemiol. 1996 Oct;25(5):948-52
8921479
Am J Cardiol. 2007 Apr 1;99(7):1016-9
17398204
JAMA. 2001 May 16;285(19):2486-97
11368702
N Engl J Med. 2000 Dec 28;343(26):1934-41
11136265
Med Care. 1992 May;30(5):377-91
1583916
J Am Coll Cardiol. 2006 Aug 15;48(4):761-4
16904546
J Am Coll Cardiol. 2006 Mar 7;47(5):921-9
16516072