Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.
Med Sci Monit. 2012 Mar;18(3):CR131-4. doi: 10.12659/msm.882517.
To investigate the incidence of death and of new cardiovascular events at long-term follow-up of patients with and without PAD seen in a vascular surgery clinic.
MATERIAL/METHODS: We investigated the incidence of death, new stroke/transient ischemic attack, new myocardial infarction, new coronary revascularization, new carotid endarterectomy, new peripheral arterial disease (PAD) revascularization, or at least one of the above outcomes at long-term follow-up of patients with and without PAD followed in a vascular surgery clinic.
At least one of the above outcomes occurred in 259 of 414 patients (63%) with PAD at 33-month follow-up and in 21 of 89 patients (24%) without PAD at 48-month follow-up (p<0.0001). Death occurred in 112 of 414 patients (27%) with PAD and in 10 of 89 patients (11%) without PAD (p=0.002). Stepwise Cox regression analysis for the time to at least one of the 6 outcomes showed that significant independent risk factors were men (hazard ratio =1.394; 95% CI, 1.072-1.813; p=0.013), estimated glomerular filtration rate (hazard ratio =0.992; 95% CI, 0.987-0.997; p=0.003), and PAD (hazard ratio =3.520; 95% CI, 2.196-5.641; p<0.0001). Stepwise Cox regression analysis for the time to death showed that significant independent risk factors were age (hazard ratio =1.024; 95% CI, 1.000-1.049; p=0.048), estimated glomerular filtration rate (hazard ratio =0.985; 95% CI, 0.974-0.996; p=0.007), and PAD (hazard ratio =2.157; 95% CI, 1.118-4.160; p=0.022).
Patients with PAD have a significantly higher incidence of cardiovascular outcomes, especially death, new PAD revascularization, and new carotid endarterectomy, than patients without PAD followed in a vascular surgery clinic.
研究血管外科诊所就诊的伴有和不伴有 PAD 的患者在长期随访中死亡和新心血管事件的发生率。
材料/方法：我们调查了伴有和不伴有 PAD 的患者在血管外科诊所随访 33 个月时至少发生上述一种结局的发生率，以及随访 48 个月时无 PAD 的患者至少发生上述一种结局的发生率。
在伴有 PAD 的 414 例患者中，有 259 例（63%）在 33 个月时至少发生了上述一种结局，而在无 PAD 的 89 例患者中，有 21 例（24%）在 48 个月时至少发生了上述一种结局（p<0.0001）。在伴有 PAD 的 414 例患者中，有 112 例（27%）死亡，而在无 PAD 的 89 例患者中，有 10 例（11%）死亡（p=0.002）。对至少发生上述 6 种结局之一的时间进行逐步 Cox 回归分析显示，男性（危险比=1.394；95%CI，1.072-1.813；p=0.013）、估计肾小球滤过率（危险比=0.992；95%CI，0.987-0.997；p=0.003）和 PAD（危险比=3.520；95%CI，2.196-5.641；p<0.0001）是独立的显著危险因素。对死亡时间进行逐步 Cox 回归分析显示，年龄（危险比=1.024；95%CI，1.000-1.049；p=0.048）、估计肾小球滤过率（危险比=0.985；95%CI，0.974-0.996；p=0.007）和 PAD（危险比=2.157；95%CI，1.118-4.160；p=0.022）是独立的显著危险因素。
与血管外科诊所就诊的不伴有 PAD 的患者相比，伴有 PAD 的患者发生心血管结局的风险显著更高，尤其是死亡、新发 PAD 血运重建和新发颈动脉内膜切除术。
