15-years mortality in patients with peripheral arterial occlusive disease
Abstract
Background: The aim of this study was to assess the risk of total and cardiovascular mortality in older adults with a low ankle-brachial index (ABI) as a marker of peripheral arterial occlusive disease (PAOD).
Patients and methods: The test group included 87 PAOD patients, 49 males and 38 females aged between 52 and 86. The control group consisted of 87 subjects without PAOD, who were comparable to the test group by age, sex and profession. PAOD were diagnosed in the lower extremities by means Doppler ultrasound (ABI was between 0.50 and 0.90). Participants were evaluated in the period of 15 years to determine cause of death. Total and cardiovascular disease mortality rates were assessed in relationship to cardiovascular risk factors and the presence of a low ABI. Chi-square test and survival analysis were used to assess the differences in mortality between test and control group.
Results: In subjects with PAOD, test group, total mortality rates was 71 (81.6%) and in control group 49 (56.3%). In the same time cardiovascular mortality in PAOD group was 55 (63.2%) and in control group 31 (35.6%). A low ABI was related to an increased risk of total (p < 0.001) and cardiovascular mortality (p < 0.001). A mean survival time of the PAOD group in the observation period was 5.4 years, while 8.7 years was a mean survival time in the group with normal ABI. The PAOD subgroup consisted of the individuals below 65 years of age had a mean survival time of 6.5 years in a 15-year period, whereas a mean survival time of the normal ABI in the same age bracket was 12.8 years (p < 0.05).
Conclusions: A low ABI has a significantly great predictive value for a total and cardiovascular mortality. In case a decreased ABI is found, measures to retard further progress of atherosclerosis should be applied.
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References
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