Cohort study examining the prevalence and relationship with outcome of standard modifiable risk factors in patients with peripheral artery occlusive and aneurysmal disease

Golledge, Jonathan, Velu, Ramesh, Quigley, Frank, Jenkins, Jason, and Singh, Tejas (2022) Cohort study examining the prevalence and relationship with outcome of standard modifiable risk factors in patients with peripheral artery occlusive and aneurysmal disease. European Journal of Vascular and Endovascular Surgery, 63 (2). pp. 305-313.

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Abstract

Objective: The aim was to examine the presentation and outcome of patients with peripheral artery occlusive and aneurysmal disease (POAD) in relation to standard modifiable cardiovascular risk factors (SMuRFs; i.e., hypertension, diabetes, hypercholesterolaemia, and smoking).

Methods: A total of 2 129 participants with POAD were recruited from three vascular clinics in Queensland, Australia. SMuRFs were defined using established criteria. Participants were followed via outpatient appointments and linked data to record the primary outcome event of major adverse cardiovascular events (MACE). The association between SMuRFs and MACE was assessed using Cox proportional hazard analysis. Subanalyses examined the association of individual SMuRFs with MACE and assessed findings separately in participants with occlusive and aneurysmal disease.

Results: At recruitment 71 (3.3%), 551 (25.9%), 977 (45.9%), 471 (22.1%), and 59 (2.8%) participants had zero, one, two, three, and four SMuRFs. During a median follow up of 2.6 (interquartile range 0.4, 6.2) years, the risk of MACE was progressively higher with the increasing numbers of SMuRFs (adjusted hazard ratio [HR] 95% confidence interval [CI] 4.09, 1.29 – 12.91; 4.28, 1.37 – 13.41; 5.82, 1.84 – 18.39; and 9.42, 2.77 – 32.08; for one, two, three, or four SMuRFs, respectively) by comparison with those who were SMuRF-less at recruitment. Participants with occlusive disease were significantly more likely to have a greater number of SMuRFs than those with aneurysmal disease. In a subanalysis, there was a significantly higher risk of MACE with three or four SMuRFs in participants presenting with either occlusive or aneurysmal disease compared with those who were SMuRF-less. Hypertension, diabetes, and smoking but not hypercholesterolaemia were independently associated with increased risk of MACE.

Conclusion: Very few patients presenting with POAD had no SMuRFs. There was a progressive increase in the risk of MACE in relation to the number of SMuRFs identified at entry.

Item ID: 73136
Item Type: Article (Research - C1)
ISSN: 1532-2165
Keywords: Abdominal aortic aneurysm, Aortic aneurysm, Carotid artery disease, Major adverse cardiovascular events, Mortality, Peripheral artery disease, Risk factors
Funders: National Health and Medical Research Council (NHMRC)
Projects and Grants: NHMRC 1063476, NHMRC 1180736, NHMRC 1117061
Date Deposited: 23 Mar 2022 08:02
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320199 Cardiovascular medicine and haematology not elsewhere classified @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100%
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