Undiagnosed peripheral artery disease common among high-risk patients
Undiagnosed peripheral arterial disease (PAD) is common among high-risk patients, reports a new Australia study.
Drawing from the Australian Reduction of Atherothrombosis for Continued Health Registry, researchers identified 2,489 patients (mean age, 72.8±8.8 years; 65.3 percent male) who were at high risk of atherothrombosis. Only those without prior PAD diagnoses and had an ankle-brachial index (ABI) <1.4 at recruitment were eligible.
Of the participants, 34 percent were positive for PAD, with around 28 percent having low ABI (ABI+’; ABI<0.9) and 11 percent having intermittent claudication (IC). Overall, the rates of all-cause mortality and PAD events in the overall cohort were low, at 2 percent and 1.2 percent, respectively.
Disaggregation showed that all-cause mortality (2.9 percent vs 1.6 percent) and PAD events (2.1 percent vs 0.9 percent) occurred more commonly in ABI+ patients. IC patients, on the other hand, were more likely to experience nonfatal events (11.8 percent vs 8.3 percent) and PAD events (4.8 percent vs 0.8 percent). Moreover, Cox regression analysis found that PAD events were more likely to occur in patients who were positive for IC, regardless of whether IC was normal or low.
One-year follow-up data was available for 2,013 patients, of whom 123 (6 percent) developed IC. In this group, the risk of IC was 1.6-times higher in participants with low ABI as compared with those who had normal ABI values.