Associations of symptomatic or asymptomatic peripheral arterial disease with all-cause mortality and cardiovascular mortality

AbstractBackgroundTo investigate the rate of all cause and cardiovascular mortality in patients with symptomatic or asymptomatic peripheral arterial disease (PAD) compared to those without PAD.Methods and resultsAll the subjects were inpatients at high risk of atherosclerosis and enrolled from February to November, 2006. A total of 320 were followed up until an end-point (death) was reached or until February 2010. The mean follow-up time was 37.7±1.5months. Compared with non-PAD, PAD patients had significantly higher rates of hypertension, diabetes mellitus, and smoking (P<0.01). Those with symptomatic and asymptomatic PAD had a much higher all cause (37.5% and 23.0% vs. 12.1%) and cardiovascular mortality (18.8% and 13.8% vs. 6.7%) compared to those without PAD (P<0.001). The symptomatic PAD patients were 1.831 times (95% CI: 1.222–2.741) as likely to die as those without PAD, and 1.646 times (95% CI: 1.301–2.083) in asymptomatic PAD patients after adjusting for other factors. Those with symptomatic or asymptomatic PAD were more than twice as likely to die of CVD as those without PAD (RR: 2.248, 95% CI: 1.366–3.698 and RR: 2.105, 95% CI: 1.566–2.831, respectively).ConclusionsPAD was associated with a higher all cause and cardiovascular mortality whether or not PAD is symptomatic

Gender-specific association between carotid intima-media thickness and Reynolds risk score

Background and aim: Appropriate assessment and prevention of cardiovascular (CV) disease is one of the most important medical tasks worldwide. Carotid artery intima-media thickness (CIMT) is a marker of atherosclerosis, which has been associated with CV events. We examined the associations of a panel of different clinical, laboratory, and ultrasound variables simultaneously and individually with CIMT; to reveal the presence of additional surrogate markers of atherosclerosis to CIMT. Subjects and methods: 407 Consecutive non-diabetic individuals (220 men) who underwent comprehensive CV evaluation were included. The maximum IMT of the common and internal carotid artery on the right and left side of the neck were recorded by ultrasonography, and CIMT was calculated as the average of the four measurements. Ten-year Reynolds risk score (RRS) for CV events was calculated online for men and women. CAVI was measured using a VaSera vascular screening system, and the averages of the right and left CAVI were used for analysis after being adjusted for age. Results: Univariate linear regression models were constructed to test the association of each of the independent variables with the log-transformed CIMT values [Ln (average CIMT) + 2] separately for men and women. Only the variables with non-adjusted p ⩽ 0.1 were included in the final multivariately-adjusted stepwise linear regression model. After multivariate adjustment, only two variables were significantly and independently associated with log-transformed CIMT values in males (the log-transformed Reynolds risk score and the average age-matched CAVI) and females (the average age-matched CAVI and systolic blood pressure). Conclusion: RRS could be a candidate marker of atherosclerosis in men but not in women, while age-adjusted CAVI could be considered a marker of atherosclerosis in both genders