Patients with coronary, cerebrovascular or peripheral arterial obstructive disease differ in risk for new vascular events and mortality: the SMART study.
OBJECTIVE
Atherosclerosis causes coronary artery disease (CAD), cerebrovascular disease (CVD) or peripheral arterial obstructive disease (PAOD). The risk of new vascular events and mortality is high. Direct comparisons of vascular event rates are scarce.


RESULTS
Vascular risk factors and outcome events of 3563 patients from a university hospital presenting with nondisabling CAD, CVD or PAOD were compared with regression analyses, adjusted for age and sex (median follow-up, 3.9 years). The primary outcome was the composite of myocardial infarction, stroke and vascular death. The risk among the three groups of outcomes was compared using the Cox regression analysis. At baseline, CAD patients were the most obese; PAOD patients smoked the most and suffered more often from hypertension and hyperlipidaemia. The average rate of vascular events was 2.5% per year; the hazard ratio (HR) of CVD/CAD was 1.7 [95% confidence interval (CI): 1.3-2.2] and PAOD/CAD was 1.8 (95% CI: 1.5-2.0). PAOD patients had a higher risk for coronary events than CAD (HR: 1.6; 95% CI: 1.2-2.1). Patients with CVD or PAOD had a higher risk for major bleeding than CAD patients (HR: 2.1; 95% CI: 1.4-3.2).


CONCLUSIONS
Patients with a recent CVD or PAOD have almost twice the risk for future vascular events than those with CAD.
Achterberg
Sefanja
S
Department of Neurology, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands.
Cramer
Maarten J M
MJ
Kappelle
L Jaap
LJ
de Borst
Gert Jan
GJ
Visseren
Frank L J
FL
van der Graaf
Yolanda
Y
Algra
Ale
A
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000401:mortality; D023921:Coronary Stenosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors