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Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study
Aims Lower extremity peripheral artery disease (PAD) has been proposed as a ‘coronary heart disease (CHD) risk equivalent’. We aimed to examine whether PAD confers similar risk for mortality as incident myocardial infarction (MI) and whether risk differs by gender. Methods Using nationwide Danish ad...
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| Published in: | European journal of preventive cardiology 2015-03, Vol.22 (3), p.317-325 |
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| container_title | European journal of preventive cardiology |
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| creator | Subherwal, Sumeet Patel, Manesh R Kober, Lars Peterson, Eric D Bhatt, Deepak L Gislason, Gunnar H Olsen, Anne-Marie Schjerning Jones, William S Torp-Pedersen, Christian Fosbol, Emil L |
| description | Aims
Lower extremity peripheral artery disease (PAD) has been proposed as a ‘coronary heart disease (CHD) risk equivalent’. We aimed to examine whether PAD confers similar risk for mortality as incident myocardial infarction (MI) and whether risk differs by gender.
Methods
Using nationwide Danish administrative registries (2000–2008), we identified patients aged ≥40 years with incident PAD (PAD only, n = 35,628), incident PAD with a history of MI (PAD + MI, n = 7029), and incident MI alone (MI alone, n = 71,115).
Results
Patients with PAD only tended to be younger, female, and have less comorbidity than the other groups. During follow up (median 1051 d, IQR 384–1938), we found that MI-alone patients had greater risk of adverse outcomes in the acute setting (first 90 d); however, the PAD-only and PAD + MI groups had higher long-term mortality at 7 years than those with MI alone (47.8 and 60.4 vs. 36.4%, respectively; p |
| doi_str_mv | 10.1177/2047487313519344 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1654702706</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2047487313519344</sage_id><sourcerecordid>1654702706</sourcerecordid><originalsourceid>FETCH-LOGICAL-c337t-3d498c11c2d0227ce6aaa4bd2cad8ce5b68c160486bb01c0039d3bdd0af9358e3</originalsourceid><addsrcrecordid>eNp1UD1PwzAUtBAIELAzIY8sATt2Y4cNIb4kJBhgjl7s19aQ2MVOqJj46xi1dEDiLe_p7t5Jd4Qcc3bGuVLnJZNKaiW4mPBaSLlF9n-gQmrNtze3EnvkKKVXlqdiZan1Ltkrpai1qOp98vWE0S3mGKGjEAeMn9S6hJCQukSBmhCDh4zOMdMbLrr0RvF9dB_QoR8o9MHPaBuGOe3RU_CWLkO-LmjENHZDotMY-uznYXDBL51FmobRfh6SnSl0CY_W-4C83Fw_X90VD4-391eXD4URQg2FsLLWhnNT2pxBGawAQLa2NGC1wUlbZbZiUldty7hhTNRWtNYymNZiolEckNOV7yKG9xHT0PQuGew68BjG1PBqIhUrFauylK2kJoaUIk6bRXR97qDhrPlpvvnbfH45WbuPbY928_DbcxYUK0GCGTavYYw-p_3f8BvRH40c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1654702706</pqid></control><display><type>article</type><title>Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study</title><source>Oxford Journals Online</source><creator>Subherwal, Sumeet ; Patel, Manesh R ; Kober, Lars ; Peterson, Eric D ; Bhatt, Deepak L ; Gislason, Gunnar H ; Olsen, Anne-Marie Schjerning ; Jones, William S ; Torp-Pedersen, Christian ; Fosbol, Emil L</creator><creatorcontrib>Subherwal, Sumeet ; Patel, Manesh R ; Kober, Lars ; Peterson, Eric D ; Bhatt, Deepak L ; Gislason, Gunnar H ; Olsen, Anne-Marie Schjerning ; Jones, William S ; Torp-Pedersen, Christian ; Fosbol, Emil L</creatorcontrib><description>Aims
Lower extremity peripheral artery disease (PAD) has been proposed as a ‘coronary heart disease (CHD) risk equivalent’. We aimed to examine whether PAD confers similar risk for mortality as incident myocardial infarction (MI) and whether risk differs by gender.
Methods
Using nationwide Danish administrative registries (2000–2008), we identified patients aged ≥40 years with incident PAD (PAD only, n = 35,628), incident PAD with a history of MI (PAD + MI, n = 7029), and incident MI alone (MI alone, n = 71,115).
Results
Patients with PAD only tended to be younger, female, and have less comorbidity than the other groups. During follow up (median 1051 d, IQR 384–1938), we found that MI-alone patients had greater risk of adverse outcomes in the acute setting (first 90 d); however, the PAD-only and PAD + MI groups had higher long-term mortality at 7 years than those with MI alone (47.8 and 60.4 vs. 36.4%, respectively; p < 0.0001). After adjustment, the PAD-only and PAD + MI groups had a higher long-term risk for mortality [hazard ratio (HR) 1.47, 95% confidence interval (CI) 1.44–1.51; and HR 1.65, 95% CI 1.58–1.72, respectively], cardiovascular mortality (HR 1.30, 95% CI 1.26–1.34; and HR 1.71, 95% CI 1.62–1.80, respectively), and composite of death, MI, and ischaemic stroke, 95% CI HR, 1.38, 95% CI 1.36–1.42; and HR 1.68, 95% CI 1.61–1.75, respectively). The greater long-term risks of PAD were seen for both women and men.
Conclusions
Both women and men with incident PAD have greater long-term risks of total and cardiovascular mortality vs. those with incident MI. PAD should be considered a CHD risk equivalent, warranting aggressive secondary prevention.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1177/2047487313519344</identifier><identifier>PMID: 24398369</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; Comorbidity ; Denmark - epidemiology ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Lower Extremity - blood supply ; Male ; Middle Aged ; Myocardial Infarction - diagnosis ; Myocardial Infarction - epidemiology ; Myocardial Infarction - mortality ; Peripheral Arterial Disease - diagnosis ; Peripheral Arterial Disease - epidemiology ; Peripheral Arterial Disease - mortality ; Proportional Hazards Models ; Registries ; Risk Assessment ; Risk Factors ; Sex Factors ; Time Factors</subject><ispartof>European journal of preventive cardiology, 2015-03, Vol.22 (3), p.317-325</ispartof><rights>The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><rights>The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-3d498c11c2d0227ce6aaa4bd2cad8ce5b68c160486bb01c0039d3bdd0af9358e3</citedby><cites>FETCH-LOGICAL-c337t-3d498c11c2d0227ce6aaa4bd2cad8ce5b68c160486bb01c0039d3bdd0af9358e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24398369$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Subherwal, Sumeet</creatorcontrib><creatorcontrib>Patel, Manesh R</creatorcontrib><creatorcontrib>Kober, Lars</creatorcontrib><creatorcontrib>Peterson, Eric D</creatorcontrib><creatorcontrib>Bhatt, Deepak L</creatorcontrib><creatorcontrib>Gislason, Gunnar H</creatorcontrib><creatorcontrib>Olsen, Anne-Marie Schjerning</creatorcontrib><creatorcontrib>Jones, William S</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Fosbol, Emil L</creatorcontrib><title>Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study</title><title>European journal of preventive cardiology</title><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><description>Aims
Lower extremity peripheral artery disease (PAD) has been proposed as a ‘coronary heart disease (CHD) risk equivalent’. We aimed to examine whether PAD confers similar risk for mortality as incident myocardial infarction (MI) and whether risk differs by gender.
Methods
Using nationwide Danish administrative registries (2000–2008), we identified patients aged ≥40 years with incident PAD (PAD only, n = 35,628), incident PAD with a history of MI (PAD + MI, n = 7029), and incident MI alone (MI alone, n = 71,115).
Results
Patients with PAD only tended to be younger, female, and have less comorbidity than the other groups. During follow up (median 1051 d, IQR 384–1938), we found that MI-alone patients had greater risk of adverse outcomes in the acute setting (first 90 d); however, the PAD-only and PAD + MI groups had higher long-term mortality at 7 years than those with MI alone (47.8 and 60.4 vs. 36.4%, respectively; p < 0.0001). After adjustment, the PAD-only and PAD + MI groups had a higher long-term risk for mortality [hazard ratio (HR) 1.47, 95% confidence interval (CI) 1.44–1.51; and HR 1.65, 95% CI 1.58–1.72, respectively], cardiovascular mortality (HR 1.30, 95% CI 1.26–1.34; and HR 1.71, 95% CI 1.62–1.80, respectively), and composite of death, MI, and ischaemic stroke, 95% CI HR, 1.38, 95% CI 1.36–1.42; and HR 1.68, 95% CI 1.61–1.75, respectively). The greater long-term risks of PAD were seen for both women and men.
Conclusions
Both women and men with incident PAD have greater long-term risks of total and cardiovascular mortality vs. those with incident MI. PAD should be considered a CHD risk equivalent, warranting aggressive secondary prevention.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Comorbidity</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kaplan-Meier Estimate</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Peripheral Arterial Disease - diagnosis</subject><subject>Peripheral Arterial Disease - epidemiology</subject><subject>Peripheral Arterial Disease - mortality</subject><subject>Proportional Hazards Models</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Time Factors</subject><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1UD1PwzAUtBAIELAzIY8sATt2Y4cNIb4kJBhgjl7s19aQ2MVOqJj46xi1dEDiLe_p7t5Jd4Qcc3bGuVLnJZNKaiW4mPBaSLlF9n-gQmrNtze3EnvkKKVXlqdiZan1Ltkrpai1qOp98vWE0S3mGKGjEAeMn9S6hJCQukSBmhCDh4zOMdMbLrr0RvF9dB_QoR8o9MHPaBuGOe3RU_CWLkO-LmjENHZDotMY-uznYXDBL51FmobRfh6SnSl0CY_W-4C83Fw_X90VD4-391eXD4URQg2FsLLWhnNT2pxBGawAQLa2NGC1wUlbZbZiUldty7hhTNRWtNYymNZiolEckNOV7yKG9xHT0PQuGew68BjG1PBqIhUrFauylK2kJoaUIk6bRXR97qDhrPlpvvnbfH45WbuPbY928_DbcxYUK0GCGTavYYw-p_3f8BvRH40c</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Subherwal, Sumeet</creator><creator>Patel, Manesh R</creator><creator>Kober, Lars</creator><creator>Peterson, Eric D</creator><creator>Bhatt, Deepak L</creator><creator>Gislason, Gunnar H</creator><creator>Olsen, Anne-Marie Schjerning</creator><creator>Jones, William S</creator><creator>Torp-Pedersen, Christian</creator><creator>Fosbol, Emil L</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study</title><author>Subherwal, Sumeet ; Patel, Manesh R ; Kober, Lars ; Peterson, Eric D ; Bhatt, Deepak L ; Gislason, Gunnar H ; Olsen, Anne-Marie Schjerning ; Jones, William S ; Torp-Pedersen, Christian ; Fosbol, Emil L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-3d498c11c2d0227ce6aaa4bd2cad8ce5b68c160486bb01c0039d3bdd0af9358e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Comorbidity</topic><topic>Denmark - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kaplan-Meier Estimate</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Peripheral Arterial Disease - diagnosis</topic><topic>Peripheral Arterial Disease - epidemiology</topic><topic>Peripheral Arterial Disease - mortality</topic><topic>Proportional Hazards Models</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Subherwal, Sumeet</creatorcontrib><creatorcontrib>Patel, Manesh R</creatorcontrib><creatorcontrib>Kober, Lars</creatorcontrib><creatorcontrib>Peterson, Eric D</creatorcontrib><creatorcontrib>Bhatt, Deepak L</creatorcontrib><creatorcontrib>Gislason, Gunnar H</creatorcontrib><creatorcontrib>Olsen, Anne-Marie Schjerning</creatorcontrib><creatorcontrib>Jones, William S</creatorcontrib><creatorcontrib>Torp-Pedersen, Christian</creatorcontrib><creatorcontrib>Fosbol, Emil L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Subherwal, Sumeet</au><au>Patel, Manesh R</au><au>Kober, Lars</au><au>Peterson, Eric D</au><au>Bhatt, Deepak L</au><au>Gislason, Gunnar H</au><au>Olsen, Anne-Marie Schjerning</au><au>Jones, William S</au><au>Torp-Pedersen, Christian</au><au>Fosbol, Emil L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>22</volume><issue>3</issue><spage>317</spage><epage>325</epage><pages>317-325</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Aims
Lower extremity peripheral artery disease (PAD) has been proposed as a ‘coronary heart disease (CHD) risk equivalent’. We aimed to examine whether PAD confers similar risk for mortality as incident myocardial infarction (MI) and whether risk differs by gender.
Methods
Using nationwide Danish administrative registries (2000–2008), we identified patients aged ≥40 years with incident PAD (PAD only, n = 35,628), incident PAD with a history of MI (PAD + MI, n = 7029), and incident MI alone (MI alone, n = 71,115).
Results
Patients with PAD only tended to be younger, female, and have less comorbidity than the other groups. During follow up (median 1051 d, IQR 384–1938), we found that MI-alone patients had greater risk of adverse outcomes in the acute setting (first 90 d); however, the PAD-only and PAD + MI groups had higher long-term mortality at 7 years than those with MI alone (47.8 and 60.4 vs. 36.4%, respectively; p < 0.0001). After adjustment, the PAD-only and PAD + MI groups had a higher long-term risk for mortality [hazard ratio (HR) 1.47, 95% confidence interval (CI) 1.44–1.51; and HR 1.65, 95% CI 1.58–1.72, respectively], cardiovascular mortality (HR 1.30, 95% CI 1.26–1.34; and HR 1.71, 95% CI 1.62–1.80, respectively), and composite of death, MI, and ischaemic stroke, 95% CI HR, 1.38, 95% CI 1.36–1.42; and HR 1.68, 95% CI 1.61–1.75, respectively). The greater long-term risks of PAD were seen for both women and men.
Conclusions
Both women and men with incident PAD have greater long-term risks of total and cardiovascular mortality vs. those with incident MI. PAD should be considered a CHD risk equivalent, warranting aggressive secondary prevention.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>24398369</pmid><doi>10.1177/2047487313519344</doi><tpages>9</tpages></addata></record> |
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| source | Oxford Journals Online |
| subjects | Adult Age Factors Aged Aged, 80 and over Comorbidity Denmark - epidemiology Female Humans Incidence Kaplan-Meier Estimate Lower Extremity - blood supply Male Middle Aged Myocardial Infarction - diagnosis Myocardial Infarction - epidemiology Myocardial Infarction - mortality Peripheral Arterial Disease - diagnosis Peripheral Arterial Disease - epidemiology Peripheral Arterial Disease - mortality Proportional Hazards Models Registries Risk Assessment Risk Factors Sex Factors Time Factors |
| title | Peripheral artery disease is a coronary heart disease risk equivalent among both men and women: results from a nationwide study |
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