Document Detail

Long-term outcome of patients with mild intermittent claudication under secondary prevention.
MedLine Citation:
PMID:  19998255     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The known natural history of peripheral arterial disease (PAD) is determined by the generalization of atherosclerosis with resulting high cardiovascular and cerebrovascular morbidity and mortality. The aim of this prospective study was to record all vascular and non-vascular events in patients with mild intermittent claudication (IC) undergoing secondary preventive measures in a 10-year follow-up and to determine the time-points at which systemic localizations of atherosclerotic events develop.
PATIENTS AND METHODS: Patients who originally had an isolated Fontaine stage IIa PAD were included in the follow-up which involved assessments carried out on an annual basis. The incidence and timepoints of vascular (i.e., myocardial infarction, stroke, critical limb ischemia, vascular death), and nonvascular events (i.e., cancer, non vascular death) were recorded and compared with the known natural history.
RESULTS: 534 events (vascular: 433) concerning 109 claudicants (M/F: 88/21; 60.8 +/- 8.8 years; ABI 0.66 +/- 0.11) were recorded over an average follow-up period of 104 months. 25.7% of the claudicants died, 39% due to vascular events, 36% due to cancer disease and 25% due to other events. A deterioration of PAD (n = 108) was the most frequent event after 20 months, followed by angina pectoris (n = 41) and cancer diseases (n = 20) after 42 and 45 months, stroke (n = 19) after 58 months, myocardial infarction (n = 12) after 63 months, and finally critical limb ischemia (n = 27) and amputations (n = 10) after 80 and 114 months (median). 111 revascularizations were carried out. 62.3% of the claudicants developed a polyvascular disease, with 20% in a trivascular territory.
CONCLUSIONS: A high vascular comorbidity also develops under secondary prevention as an expression of the continuing generalization of the atherosclerotic process in PAD. The causes for death are determined both by the vascular and the tumor related comorbidity.
B-M Taute; S Thommes; R Taute; I Rapmund; K Lindner; H Podhaisky
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  VASA. Zeitschrift für Gefässkrankheiten     Volume:  38     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-12-09     Completed Date:  2010-02-04     Revised Date:  2012-10-19    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  346-55     Citation Subset:  IM    
Department of Internal Medicine III, Martin-Luther-University of Halle-Wittenberg, Halle, Germany.
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MeSH Terms
Cardiovascular Diseases / etiology,  mortality
Cause of Death
Disease Progression
Intermittent Claudication / etiology,  mortality,  prevention & control*
Kaplan-Meier Estimate
Middle Aged
Peripheral Vascular Diseases / complications,  mortality,  therapy*
Prospective Studies
Recurrence / prevention & control
Secondary Prevention*
Severity of Illness Index
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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