Peripheral Arterial Disease Location Impacts Prognosis

Proximal disease associated with poorer general prognosis compared with more distal disease

FRIDAY, Feb. 26 (HealthDay News) -- The general prognosis in patients with peripheral arterial disease (PAD) is worse in those with proximal disease than those with more distal disease, according to research published in the March 2 issue of the Journal of the American College of Cardiology.

Victor Aboyans, M.D., of Limoges University in France, and colleagues analyzed data from 400 patients with PAD who underwent a first digital subtraction angiography of lower limb arteries. All had at least one arterial stenosis of at least 50 percent due to atherosclerosis. Patients were followed for roughly 34 months for a combination of death, myocardial infarction, stroke, and coronary or carotid revascularization. The authors defined proximal PAD as aortoiliac disease and distal PAD as infrailiac disease.

After adjustment for a variety of factors, including age, sex and cardiovascular disease history, the researchers found that proximal PAD was associated with a worse prognosis (hazard ratio for the primary outcome, 3.28; hazard ratio for death, 3.18).

"Among PAD patients, those with proximal lesions have a 2.5- to 3.5-fold risk of mortality and cardiovascular disease events compared with those with distal PAD. This association is independent of several risk factors and comorbidities, which are differentially associated with these two localizations of PAD. Our results contrast with the poorer limb prognosis in cases of distal PAD. Our finding is limited to hospitalized PAD patients and needs further confirmation in prospective population studies," the authors conclude.

Full Text (subscription or payment may be required)

Physician's Briefing