Document Detail

Risk factor profile, management and prognosis of patients with peripheral arterial disease with or without coronary artery disease: results of the prospective German REACH registry cohort.
MedLine Citation:
PMID:  19221687     Owner:  NLM     Status:  MEDLINE    
AIMS: Peripheral arterial disease (PAD) and coronary artery disease (CAD) are manifestations of the same underlying condition, atherothrombosis. We compared patients with PAD only with those having PAD and concomitant documented CAD in terms of characteristics, risk factors, treatment and prognosis. METHODS AND RESULTS: This is a subgroup analysis of the German cohort of the Reduction of Atherothrombosis for Continued Health (REACH) Registry. It includes 483 patients with PAD only, and 479 patients with PAD plus CAD. Patients with concomitant cerebrovascular disease were excluded. Symptomatic PAD was defined as intermittent claudication (IC), confirmed by ankle brachial index <0.9, or PAD-related intervention. Patients in the total cohort were predominantly elderly (mean age 67.3 +/- 8.9 years), males (72.3%), current or previous smokers (80.18%), and had often abdominal obesity (49.6%). Atherosclerotic risk factors and comorbidities were highly prevalent. Patients with PAD + CAD compared to those with PAD only were significantly more intensively treated with regards to antihrombotic agents (97.1% vs. 88.8%), statins (80.2% vs. 51.6%), or ACE inhibitors/ARB (75.6% vs. 61.1%). After two-year follow-up, no significant differences between subgroups were noted for total mortality (4.6% vs. 5.5%), cardiovascular mortality (3.7% vs. 3.9%), non-fatal myocardial infarction (1.9% vs. 2.7%) but for non-fatal stroke (4.4% vs. 2.0%, P < 0.05). CONCLUSION: Peripheral arterial disease patients carry a high burden of risk factors and co-morbidities, and are at high risk of death and cardiovascular events. If documented CAD is absent, PAD patients are undertreated. Thus, in PAD patients, secondary cardiovascular prevention with stringent treatment of risk factors to the same extent as in CAD patients is mandatory, in line with current guidelines.
Uwe Zeymer; Klaus G Parhofer; David Pittrow; Christiane Binz; Markus Schwertfeger; Tobias Limbourg; Joachim Röther
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-02-16
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  98     ISSN:  1861-0692     ISO Abbreviation:  -     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  249-56     Citation Subset:  IM    
Herzzentrum Ludwigshafen, Ludwigshafen, Germany.
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MeSH Terms
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Cardiovascular Diseases / mortality,  prevention & control*
Coronary Artery Disease / complications*,  physiopathology
Fibrinolytic Agents / therapeutic use
Follow-Up Studies
Germany / epidemiology
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
Intermittent Claudication / drug therapy,  etiology,  physiopathology
Middle Aged
Peripheral Vascular Diseases / drug therapy,  etiology,  physiopathology*
Practice Guidelines as Topic
Prospective Studies
Risk Factors
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Fibrinolytic Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

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