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International Angiology 2017 June;36(3):216-27

DOI: 10.23736/S0392-9590.16.03731-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Survival and event-free survival of patients with peripheral arterial disease undergoing prevention of cardiovascular disease

Aleš BLINC 1, 2, Matija KOZAK 1, 2, Mišo ŠABOVIČ 1, 2, Mojca BOŽIČ MIJOVSKI 1, 3, Mojca STEGNAR 1, 3, Pavel POREDOŠ 1, 2, Andrej KRAVOS 4, Breda BARBIČ-ŽAGAR 5, Janez STARE 6, Maja POHAR PERME 6

1 Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; 2 Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; 3 Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia; 4 Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia; 5 Krka, d. d., Novo mesto, Slovenia; 6 Institute of Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia



BACKGROUND: Patients with peripheral arterial disease (PAD) are at very high risk for cardiovascular events. How do patients with PAD differ from age- and sex-matched controls in survival, major ischemic events and revascularization procedures when both groups were managed according to the European guidelines on cardiovascular disease prevention?
METHODS: Patients with PAD (N.=742) and 713 age and sex-matched control subjects without PAD, both groups aged 65±9 years at inclusion, were managed for 5 years according to the European guidelines on cardiovascular disease prevention and evaluated yearly for occurrence of death, non-fatal major ischemic events and revascularization procedures (minor events).
RESULTS: In the PAD group, the 5-year survival was 84.7% (CI 82.1-87.3%) vs. 93.3% (CI 91.5-95.2%) in the control group, P<0.001. In the PAD group the proportion of cardiovascular deaths did not differ significantly from non-cardiovascular deaths (6.9 vs. 8.4%, P=0.14), while in the control group cardiovascular deaths were less frequent (2.4 vs. 4.3%, P=0.05). The groups differed in 5-year major event-free survival: 76.7% (CI 73.7-79.8%) in PAD vs. 89.9% (CI 87.7 -92.2%) in controls, P<0.001, and in event-free survival: 56.2% (CI 52.7-59.9%) in PAD vs. 82.4% (CI 79.9-85.3%) in controls, P<0.001.
CONCLUSIONS: Patients with PAD had a higher risk of all-cause death, major and minor non-fatal cardiovascular events compared to control subjects. In our group, cardiovascular events were not the leading cause of death in patients with PAD (ClinicalTrials.gov number NCT00761969.)


KEY WORDS: Peripheral arterial disease - Cardiovascular diseases - Prevention and control - Guidelines

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