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Impact of Clinical and Subclinical Peripheral Arterial Disease in Mid-Term Prognosis of Patients With Acute Coronary Syndrome
- Source :
- The American Journal of Cardiology. 104:1494-1498
- Publication Year :
- 2009
- Publisher :
- Elsevier BV, 2009.
-
Abstract
- Observational studies report poor prognosis of patients after acute coronary syndrome (ACS) in the presence of previous peripheral arterial disease (PAD), but data on subclinical PAD are scarce. This study was designed to assess the predictive value of clinical and subclinical PAD in the follow-up of patients after an ACS. We included 1,054 patients hospitalized for an ACS who survived the acute phase. Patients were divided into 3 groups: clinical PAD (previously diagnosed PAD or intermittent claudication), subclinical PAD (defined as ankle-brachial indexor=0.9 or1.4), and no PAD. Clinical PAD was present in 150 patients (14.2%) and 298 cases of subclinical PAD were detected (28.3%). Patients with PAD (clinical and subclinical PAD) were significantly older and had a higher prevalence of hypertension and diabetes mellitus than those without PAD. During the 1-year follow-up, 59 patients died (5.6%). Previous PAD (hazard ratio 4.38, 95% confidence interval 1.96 to 9.82, p0.001) and subclinical PAD (hazard ratio 2.35, 95% confidence interval 1.05 to 5.23, p0.05) were associated with increased cardiovascular mortality. Moreover, patients with clinical PAD had higher rates of major cardiovascular events (myocardial infarction, angina, and heart failure) than patients with subclinical PAD or without PAD. In conclusion, beyond clinical PAD, measurement of ankle-brachial index after ACS provides substantial information on intermediate-term prognosis.
- Subjects :
- Male
Acute coronary syndrome
medicine.medical_specialty
Time Factors
Severity of Illness Index
Asymptomatic
Predictive Value of Tests
Risk Factors
Surveys and Questionnaires
Diabetes mellitus
Internal medicine
Prevalence
medicine
Humans
Ankle Brachial Index
Prospective Studies
Acute Coronary Syndrome
Aged
Subclinical infection
Aged, 80 and over
Peripheral Vascular Diseases
Inpatients
Vascular disease
business.industry
Hazard ratio
Intermittent Claudication
Middle Aged
Prognosis
medicine.disease
Confidence interval
Intermittent claudication
Survival Rate
body regions
Spain
Cardiology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....ba17314309cf00a145d3f72a3c33b1d8