Ten Year Mortality in Different Peripheral Arterial Disease Stages: A Population Based Observational Study on Outcome

被引:105
作者
Sartipy, Fredrik [1 ]
Sigvant, Birgitta [2 ]
Lundin, Fredrik [3 ]
Wahlberg, Eric [4 ]
机构
[1] Karolinska Inst, Dept Clin Sci & Educ, Sect Vasc Surg, Sodersjukhuset, Stockholm, Sweden
[2] Uppsala Univ, Dept Surg Sci, Uppsala, Sweden
[3] Cty Council Varmland, Clin Res Ctr, Karlstad, Sweden
[4] Linkoping Univ, Linkoping Univ Hosp, Dept Med & Hlth, Linkoping, Sweden
关键词
Peripheral arterial disease; Mortality; Cardiovascular death; COMPETING RISKS; PRESSURE INDEX; SWEDISH; PREVALENCE; QUESTIONNAIRE; EPIDEMIOLOGY; METAANALYSIS; NATIONWIDE; PREDICTOR; MODELS;
D O I
10.1016/j.ejvs.2018.01.019
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: The aim was to determine long-term mortality rates and the underlying cause of death for subjects with different peripheral arterial disease (PAD) stages in a population based setting. Methods: A randomly selected population sample of 5080 subjects was enrolled in the study in 2004-2005. Participants completed health state questionnaires and underwent ankle brachial index (ABI) measurements for classification into PAD severity stages and reference subjects. A follow-up was conducted by the end of 2015 using data from Swedish governmental national registers for cause of death, which was then compared with PAD stage determined at baseline in 2005. Results: The 10 year all cause mortality was 27% for reference cases, 56% for asymptomatic PAD (APAD), 63% for intermittent claudication (IC), and 75% for severe limb ischaemia (SLI). Among all PAD subjects, cardiovascular (CV) causes were the most common main cause of death (45%) and a CV event was present as either the main or one of the three most common contributing causes of death in 64% of the cases. The age adjusted hazard ratios for a main cause of death by a CV event were 1.9 (95% CI 1.5-2.3) for APAD, 2.6 (95% CI 2.1-3.4) for IC, and 3.5 (95% CI 2.3-5.2) for SLI. Conclusion: PAD subjects, including the APAD subjects, are still at high risk of CV death. The mortality risks are more than doubled in symptomatic PAD patients compared with reference subjects and increase by severity of PAD stage. Awareness and improved risk reduction management of PAD are still warranted. (C) 2018 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:529 / 536
页数:8
相关论文
共 31 条
[1]   Editor's Choice-2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) [J].
Aboyans, Victor ;
Ricco, Jean-Baptiste ;
Bartelink, Marie-Louise E. L. ;
Bjorck, Martin ;
Brodmann, Marianne ;
Cohnert, Tina ;
Collet, Jean-Philippe ;
Czerny, Martin ;
De Carlo, Marco ;
Debus, Sebastian ;
Espinola-Klein, Christine ;
Kahan, Thomas ;
Kownator, Serge ;
Mazzolai, Lucia ;
Naylor, A. Ross ;
Roffi, Marco ;
Roether, Joachim ;
Sprynger, Muriel ;
Tendera, Michal ;
Tepe, Gunnar ;
Venermo, Maarit ;
Vlachopoulos, Charalambos ;
Desormais, Ileana ;
Widimsky, Petr ;
Kolh, Philippe ;
Agewall, Stefan ;
Bueno, Hector ;
Coca, Antonio ;
De Borst, Gert J. ;
Delgado, Victoria ;
Dick, Florian ;
Erol, Cetin ;
Ferrini, Marc ;
Kakkos, Stavros ;
Katus, Hugo A. ;
Knuuti, Juhani ;
Lindholt, Jes ;
Mattle, Heinrich ;
Pieniazek, Piotr ;
Piepoli, Massimo Francesco ;
Scheinert, Dierk ;
Sievert, Horst ;
Simpson, Iain ;
Sulzenko, Jakub ;
Tamargo, Juan ;
Tokgozoglu, Lale ;
Torbicki, Adam ;
Tsakountakis, Nikolaos ;
Tunon, Jose ;
Vega de Ceniga, Melina .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2018, 55 (03) :305-368
[2]   Continuing decrease in coronary heart disease mortality in Sweden [J].
Berg, Johanna ;
Bjoerck, Lena ;
Lappas, Georgios ;
O'Flaherty, Martin ;
Capewell, Simon ;
Rosengren, Annika .
BMC CARDIOVASCULAR DISORDERS, 2014, 14
[3]   Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002 [J].
Bjorck, Lena ;
Rosengren, Annika ;
Bennett, Kathleen ;
Lappas, George ;
Capewell, Simon .
EUROPEAN HEART JOURNAL, 2009, 30 (09) :1046-1056
[4]  
Cacoub Patrice P, 2009, Atherosclerosis, V204, pe86, DOI 10.1016/j.atherosclerosis.2008.10.023
[5]   Prevalence of Asymptomatic Peripheral Arterial Disease and Related Risk Factors in Younger and Elderly Patients in Taiwan [J].
Chen, Yi-Jen ;
Lin, Ming-Shian ;
Hsu, Kun-Yen ;
Chen, Cheng-Ren ;
Chen, Chuan-Mu ;
Chen, Wei .
ANGIOLOGY, 2014, 65 (05) :396-401
[6]  
COX DR, 1972, J R STAT SOC B, V34, P187
[7]   MORTALITY OVER A PERIOD OF 10 YEARS IN PATIENTS WITH PERIPHERAL ARTERIAL-DISEASE [J].
CRIQUI, MH ;
LANGER, RD ;
FRONEK, A ;
FEIGELSON, HS ;
KLAUBER, MR ;
MCCANN, TJ ;
BROWNER, D .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (06) :381-386
[8]   Epidemiology of Peripheral Artery Disease [J].
Criqui, Michael H. ;
Aboyans, Victor .
CIRCULATION RESEARCH, 2015, 116 (09) :1509-1526
[9]  
Eberhardt Robert T., 2004, Current Drug Targets - Cardiovascular & Haematological Disorders, V4, P209, DOI 10.2174/1568006043336230
[10]   Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis [J].
Fowkes, F. Gerald R. ;
Rudan, Diana ;
Rudan, Igor ;
Aboyans, Victor ;
Denenberg, Julie O. ;
McDermott, Mary M. ;
Norman, Paul E. ;
Sampson, Uchechukwe K. A. ;
Williams, Linda J. ;
Mensah, George A. ;
Criqui, Michael H. .
LANCET, 2013, 382 (9901) :1329-1340