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Long-term survival after initial hospital admission for peripheral arterial disease in the lower extremities.

Vaartjes I, de Borst GJ, Reitsma JB, de Bruin A, Moll FL, Grobbee DE, Bots ML - BMC Cardiovasc Disord (2009)

Bottom Line: Five years mortality risk was higher for men compared to women (HR 1.36, 95% CI 1.21-1.53).In conclusion, our findings demonstrate that, 5 year mortality risk is high, especially in men and comparable to that of patients admitted for acute myocardial infarction or ischemic stroke.Though, in general population the awareness of the severity of PAD in the lower extremities is significantly lower than that for any other cardiovascular disease and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest.

View Article: PubMed Central - HTML - PubMed

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. c.h.vaartjes@umcutrecht.nl

ABSTRACT

Background: As the population ages, peripheral arterial disease (PAD) in the lower extremities will become a larger public health problem. Awareness in patients as well clinicians of the high risk of morbidity and mortality is important but seems currently low. Insights in absolute mortality risks following admission for PAD in the lower extremities can be useful to improve awareness as they are easy to interpret.

Methods: A nationwide cohort of 4,158 patients with an initial admission for PAD in the lower extremities was identified through linkage of the national hospital and population register in 1997 and 2000.

Results: Over 60% of 4,158 patients were men. 28 days, 1 year and 5 year mortality risk were 2.4%, 10.3% and 31.0% for men and 3.5%, 10.4% and 27.4% for women. Coronary heart disease and stroke were frequent cause of death. Five years mortality risk was higher for men compared to women (HR 1.36, 95% CI 1.21-1.53).

Conclusion: In conclusion, our findings demonstrate that, 5 year mortality risk is high, especially in men and comparable to that of patients admitted for acute myocardial infarction or ischemic stroke. Though, in general population the awareness of the severity of PAD in the lower extremities is significantly lower than that for any other cardiovascular disease and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest.

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Mortality risk at 5 years* after a first hospital admission for PAD in the lower extremities, acute myocardial infarction and ischemic stroke, by age. Men * Mortality risks AMI, IS and GP extracted from other data [18,31,47] AMI: Acute myocardial Infarction, IS: Ischemic stroke, PAD: Peripheral arterial disease in the lower extremities, GP: General population
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Figure 1: Mortality risk at 5 years* after a first hospital admission for PAD in the lower extremities, acute myocardial infarction and ischemic stroke, by age. Men * Mortality risks AMI, IS and GP extracted from other data [18,31,47] AMI: Acute myocardial Infarction, IS: Ischemic stroke, PAD: Peripheral arterial disease in the lower extremities, GP: General population

Mentions: The long-term risk of death of patients with a first hospitalization for PAD in the lower extremities is high compared to risk of death in the general population (Figure 1 and Figure 2). Furthermore, comparison with survival after admission for other atherosclerotic diseases such as acute myocardial infarction and ischemic stroke showed similar mortality risks (Figure 1 and Figure 2) [13,18,31]. In contrast, awareness of the severity of PAD in the lower extremities is low as in general population the familiarity with this disease is significantly lower than that for any other cardiovascular disease. A recent study showed that 26% of the public was familiar with the disorder and of those only 14% was aware that the disease could lead to death [32]. Furthermore, PAD patients tend to be undertreated compared to patients with other manifestations of atherosclerosis and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest [33,34].


Long-term survival after initial hospital admission for peripheral arterial disease in the lower extremities.

Vaartjes I, de Borst GJ, Reitsma JB, de Bruin A, Moll FL, Grobbee DE, Bots ML - BMC Cardiovasc Disord (2009)

Mortality risk at 5 years* after a first hospital admission for PAD in the lower extremities, acute myocardial infarction and ischemic stroke, by age. Men * Mortality risks AMI, IS and GP extracted from other data [18,31,47] AMI: Acute myocardial Infarction, IS: Ischemic stroke, PAD: Peripheral arterial disease in the lower extremities, GP: General population
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2743645&req=5

Figure 1: Mortality risk at 5 years* after a first hospital admission for PAD in the lower extremities, acute myocardial infarction and ischemic stroke, by age. Men * Mortality risks AMI, IS and GP extracted from other data [18,31,47] AMI: Acute myocardial Infarction, IS: Ischemic stroke, PAD: Peripheral arterial disease in the lower extremities, GP: General population
Mentions: The long-term risk of death of patients with a first hospitalization for PAD in the lower extremities is high compared to risk of death in the general population (Figure 1 and Figure 2). Furthermore, comparison with survival after admission for other atherosclerotic diseases such as acute myocardial infarction and ischemic stroke showed similar mortality risks (Figure 1 and Figure 2) [13,18,31]. In contrast, awareness of the severity of PAD in the lower extremities is low as in general population the familiarity with this disease is significantly lower than that for any other cardiovascular disease. A recent study showed that 26% of the public was familiar with the disorder and of those only 14% was aware that the disease could lead to death [32]. Furthermore, PAD patients tend to be undertreated compared to patients with other manifestations of atherosclerosis and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest [33,34].

Bottom Line: Five years mortality risk was higher for men compared to women (HR 1.36, 95% CI 1.21-1.53).In conclusion, our findings demonstrate that, 5 year mortality risk is high, especially in men and comparable to that of patients admitted for acute myocardial infarction or ischemic stroke.Though, in general population the awareness of the severity of PAD in the lower extremities is significantly lower than that for any other cardiovascular disease and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest.

View Article: PubMed Central - HTML - PubMed

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. c.h.vaartjes@umcutrecht.nl

ABSTRACT

Background: As the population ages, peripheral arterial disease (PAD) in the lower extremities will become a larger public health problem. Awareness in patients as well clinicians of the high risk of morbidity and mortality is important but seems currently low. Insights in absolute mortality risks following admission for PAD in the lower extremities can be useful to improve awareness as they are easy to interpret.

Methods: A nationwide cohort of 4,158 patients with an initial admission for PAD in the lower extremities was identified through linkage of the national hospital and population register in 1997 and 2000.

Results: Over 60% of 4,158 patients were men. 28 days, 1 year and 5 year mortality risk were 2.4%, 10.3% and 31.0% for men and 3.5%, 10.4% and 27.4% for women. Coronary heart disease and stroke were frequent cause of death. Five years mortality risk was higher for men compared to women (HR 1.36, 95% CI 1.21-1.53).

Conclusion: In conclusion, our findings demonstrate that, 5 year mortality risk is high, especially in men and comparable to that of patients admitted for acute myocardial infarction or ischemic stroke. Though, in general population the awareness of the severity of PAD in the lower extremities is significantly lower than that for any other cardiovascular disease and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest.

Show MeSH
Related in: MedlinePlus