Impact of peripheral artery disease on prognosis in hospitalized heart failure patients.
BACKGROUND
The impact of peripheral artery disease (PAD) on heart failure (HF) prognosis remains unclear.


RESULTS
A total of 388 consecutive decompensated HF patients were divided into 2 groups based on the presence of PAD: HF with PAD (PAD group, n=101, 26.0%) and HF without PAD (non-PAD group, n=287, 74.0%). We compared clinical features, echocardiographic parameters, cardiopulmonary exercise testing results, laboratory findings, as well as cardiac, non-cardiac, and all-cause mortality between the 2 groups. The PAD group, as compared with the non-PAD group, had (1) higher prevalence of coronary artery disease (40.6 vs. 27.5%, P=0.011) and cerebrovascular disease (34.7 vs. 18.2%, P=0.001); (2) higher tumor necrosis factor-α (1.82 vs. 1.49 pg/ml, P=0.023), C-reactive protein (0.32 vs. 0.19 mg/dl, P=0.045), and troponin T (0.039 vs. 0.021 ng/ml, P=0.019); (3) lower LVEF (42.4 vs. 48.5%, P<0.001); (4) lower peak V̇O2(13.4 vs. 15.9 ml·kg(-1)·min(-1), P=0.001); and (5) higher V̇E/V̇CO2slope (38.8 vs. 33.7, P<0.001). On Kaplan-Meier analysis, cardiac, non-cardiac, and all-cause mortality were significantly higher in the PAD group than in the non-PAD group (P<0.05, respectively). On Cox proportional hazard analysis after adjusting for confounding factors, PAD was an independent predictor of cardiac and all-cause mortality (P<0.05, respectively) in HF patients.


CONCLUSIONS
PAD was common and an independent predictor of cardiac and all-cause mortality in HF patients.
Department of Cardiology and Hematology, Fukushima Medical University.
Yuichi
Y
Nakamura
Hiroyuki
H
Kunii
Akiomi
A
Yoshihisa
Mai
M
Takiguchi
Takeshi
T
Shimizu
Hiroyuki
H
Yamauchi
Shoji
S
Iwaya
Takashi
T
Owada
Satoshi
S
Abe
Takamasa
T
Sato
Satoshi
S
Suzuki
Masayoshi
M
Oikawa
Atsushi
A
Kobayashi
Takayoshi
T
Yamaki
Koichi
K
Sugimoto
Kazuhiko
K
Nakazato
Hitoshi
H
Suzuki
Shu-ichi
S
Saitoh
Yasuchika
Y
Takeishi
D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D015996:Survival Rate; D014463:Ultrasonography