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Control of modifiable risk factors and major adverse cardiovascular events in people with peripheral artery disease and diabetes
- Source :
- World Journal of Diabetes
- Publication Year :
- 2021
- Publisher :
- Baishideng Publishing Group Inc, 2021.
-
Abstract
- BACKGROUND People with diabetes and peripheral artery disease (PAD) have a high risk of major adverse cardiovascular events (MACE). Prior research suggests that medical therapies aimed to control modifiable risk factors are poorly implemented in patients with PAD. AIM To examine the association between the control of modifiable risk factors, estimated by the novel PAD-medical score, and the incidence of MACE in people with PAD and diabetes. METHODS Participants were recruited from out-patient clinics if they had a diagnosis of both PAD and diabetes. Control of reversible risk factors was assessed by a new composite measure, the PAD-medical score. This score takes into account the control of low-density lipoprotein cholesterol, blood pressure, blood glucose, smoking and prescription of an anti-platelet. Participants were followed to record incidence of myocardial infarction, stroke and cardiovascular death (MACE). The association of PAD-medical score with MACE was assessed using Cox proportional hazard analyses adjusting for age, sex and prior history of ischemic heart disease and stroke. RESULTS Between 2002 and 2020, a total of 424 participants with carotid artery disease (n = 63), aortic or peripheral aneurysm (n = 121) or lower limb ischemia (n = 240) were prospectively recruited, and followed for a median duration (inter-quartile range) of 2.0 (0.2–4.4) years. Only 33 (7.8%) participants had the optimal PAD-medical score of five, with 318 (75%) scoring at least three out of five. There were 89 (21.0%) participants that had at least one MACE during the follow-up period. A one-unit higher PAD-medical score was associated with lower risk of MACE (HR = 0.79, 95%CI: 0.63-0.98) after adjusting for other risk factors. CONCLUSION The PAD-medical score provides a simple way to assess the control of modifiable risk factors targeted by medical management aimed to reduce the incidence of MACE.
- Subjects :
- medicine.medical_specialty
Peripheral artery disease
Arterial disease
business.industry
Endocrinology, Diabetes and Metabolism
Major cardiovascular events
Diabetes
Observational Study
030209 endocrinology & metabolism
Disease
030204 cardiovascular system & hematology
Clinical practice
medicine.disease
Clinical Practice
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Medical management
cardiovascular diseases
Prospective study
business
Prospective cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 19489358
- Volume :
- 12
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- World Journal of Diabetes
- Accession number :
- edsair.doi.dedup.....948e3631b20cb19e94ffd3a1f13841e8