ORIGINAL ARTICLE   Free

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

DOI: 10.23736/S0392-9590.16.03731-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

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