Long-term outcome of patients with mild intermittent claudication under secondary prevention

Bm, Taute; Thommes, S.; Taute, R.; Rapmund, I; Lindner, K; Podhaisky, H

doi:10.1024/0301-1526.38.4.346

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…A total of 74 major vascular events and 111 revascularizations were recorded in the follow-up. 11 However, both vascular mortality and total mortality in the 10-year period were well below those described for the natural history and also in studies on secondary prevention measures in claudicants. [17][18][19][20][21] This needs to be discussed in the context of the inclusion criteria chosen for the study: none of the study patients had a vascular or serious nonvascular comorbidity at the start of the study and renal failure was an exclusion criterion.…”

Section: Discussionmentioning

confidence: 97%

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The Possible Risk of Cancer in Claudicants

et al. 2011

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The aim of this study was to select a group of patients who had mild intermittent claudication and were undergoing secondary prevention measures, and record all vascular and non-vascular events over a 10-year follow-up. A total of 534 events were recorded in 109 claudicants. 25.7% of the claudicants died, 39% of them due to vascular events, 36% from cancer and 25% from other causes. 17 of the 20 cancer cases could be classified as related to smoking. Cancer occurred relatively early in the study, within the first five years, while severe vascular events occurred mainly during later periods. A clear transformation occurred in the outcome of the claudicants. Mortality was equally attributable to vascular and cancer-related comorbidities. In conclusion, the improvement of vascular outcomes due to secondary prevention measures and technological advances in the management of acute vascular events may result in a relative increase in cancer incidence and deaths.

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Section: Discussionmentioning

confidence: 97%

“…Patient recruitment details have been previously described. 11 Secondary prevention measures were initiated or continued in all patients. Secondary prevention included therapy for all treatable vascular risk factors and antiplatelet therapy.…”

Section: Methodsmentioning

confidence: 99%

The Possible Risk of Cancer in Claudicants

et al. 2011

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“…Total disease cohort (APAD, symptomatic PAD, and ABI subjects) 5,10e21,23,24,28,29,31,35e51 N¼66,753 (men 61%), mean age 67 years 6. Separate by sex 13,29,31,46,48 N¼21,567 (men 56%), mean age men and women 66.1 and 66.9 years, respectively was highly variable over time in studies assessing IC revascularization (Fig. 2B).…”

Section: Disease Progression and Clinical Coursementioning

confidence: 99%

The Risk of Disease Progression in Peripheral Arterial Disease is Higher than Expected: A Meta-Analysis of Mortality and Disease Progression in Peripheral Arterial Disease

Sigvant

Lundin

Wahlberg

2016

European Journal of Vascular and Endovascular Surgery

221

127

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“…Despite the growing body of literature identifying the polyvascular phenotype as a malignant condition with extremely high cardiovascular risk, little is known about the progression of patients with PAD alone toward a polyvascular disease. Results from a prospective observational study with 109 claudicants (Fontaine stage IIa) showed that an aggravation towards a polyvascular disease occurred in over 60%, with 20% in all three vascular beds [32]. Mortality was similarly high in our population at 26%, including 39% deaths from vascular causes.…”

Section: Discussionmentioning

confidence: 52%

Prognostic Role of Polyvascular Involvement in Patients with Symptomatic Peripheral Artery Disease

Adam

Strickler

Borozadi

et al. 2023

JCM

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Background: Statin therapy is recommended for patients with peripheral artery disease (PAD). However, PAD patients with polyvascular (PV) extent remain threatened by an increased residual cardiovascular (CV) risk. Purpose: To investigate the association of prescribed statin therapy and mortality in PAD patients with or without PV extent. Methods: A single-center retrospective longitudinal observational study originating from a consecutive registry with 1380 symptomatic PAD patients over a mean observational time of 60 ± 32 months. The association of atherosclerotic extent and statin use (PAD, plus one additional region (CAD or CeVD, [+1 V]), +2 vascular regions (+CAD and CeVD [+2 V]) with the risk of all-cause mortality was evaluated using Cox proportional hazard models adjusted for potential confounding factors. Results: The mean age of the study’s participants was 72.0 ± 11.7 years, with 36% being female. PAD patients with PV extent [+1 V] and [+2 V] were older and suffered from diabetes, hypertension, or dyslipidemia more often; they, too, had more severely impaired kidney function (all p < 0.0001) compared to patients with PAD only. PAD patients with PV [+1 V] and [+2 V] received better statin medication and reached the recommended LDL-C target compared to PAD-only patients (p < 0.001). Despite better statin treatment, the rate of all-cause mortality was higher in PV patients than in PAD-only patients (PAD only: 13%; [+1 V]: 22%; [+2 V]: 35%; p < 0.0001). Conclusion: PV patients receive better statin therapy than PAD-only patients but nevertheless still have higher mortality rates. Future studies are needed to explore whether more aggressive LDL-lowering treatment for PAD patients may be translated into better prognosis.

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Long-term outcome of patients with mild intermittent claudication under secondary prevention

Abstract: 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.

Cited by 4 publications

References 22 publications

The Possible Risk of Cancer in Claudicants

The Possible Risk of Cancer in Claudicants

The Risk of Disease Progression in Peripheral Arterial Disease is Higher than Expected: A Meta-Analysis of Mortality and Disease Progression in Peripheral Arterial Disease

Prognostic Role of Polyvascular Involvement in Patients with Symptomatic Peripheral Artery Disease

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