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Home > Vascular Annual Meeting > aboyans_risk_factors

Risk Factors and Cardiovascular Prognosis of Patients with Peripheral Arterial Disease Differ According to the Disease Localization

Victor Aboyans¹, Ileana Desormais¹, Philippe Lacroix¹, Khaief Rhaiem¹, Johanna Salazar¹, Mark Laskar¹, Michael H. Criqui², Arnost Fronek.^2
1Dupuytren University Hospital, Limoges, France;²University of California, San Diego, La Jolla, Calif.
 
OBJECTIVES: Peripheral arterial disease (PAD) is associated with poor cardiovascular (CV) prognosis. It is unknown whether this prognosis could differ according to PAD lesions topography.

METHODS: We reviewed the data of all patients who underwent a first lower limbs angiography between 01/2000 and 12/2005 in our hospital. Arterial stenoses >50% were located by 2 experienced vascular physicians. Following events were collected until 04/2007: death, non-fatal myocardial infarction or stroke, coronary or carotid revascularization. The primary outcome combined all adverse events.

RESULTS: We studied 400 PAD cases (age 68.3±12.3 y, 77.5% males). Aorto-iliac disease (AI-PAD) and infra-iliac disease were noted in 211 (52.8%) and 251 (62.8%) cases respectively. Male sex and smoking were more prevalent in AI-PAD while older age, diabetes, hypertension, renal failure and critical ischemia were significantly more prevalent in infra-iliac disease (p<0.05). During the follow-up period, the event-free survival curves differed according to PAD topography [Figure 1]. Adjusted to age, sex, CV disease history and risk factors, critical ischemia and treatments, AI-PAD was significantly associated to worse prognosis (primary outcome: OR=3.28, death: OR=3.18, p<0.002).

Conclusion: The association between CV risk factors and PAD differs according to the lesions localization. This is the first study reporting the worse general prognosis of patients with aorto-iliac disease, compared to those with other localizations of PAD, independent of risk factors and comorbidities.

AUTHOR DISCLOSURES: V. Aboyans, None; I. Desormais, None; P. Lacroix, None; K. Rhaiem, None; J. Salazar, None; M. Laskar, None; M.H. Criqui, None; A. Fronek, None.

Figure 1.