Study Title
PREvalence of peripheral arterial disease in acute coronary Syndrome patiENTs
Secondary:
To identify the Main Clinical Variables associated with a higher risk of PAD among
this population
To evaluate the therapeutic management of these patients
To train Cardiologists to measure Ankle / Brachial Index (ABI) in order to improve
diagnosis of PAD
Summary:
Population studied : 100 patients , with the following gender distribution 75% male and
25% female and with mean age of 63.86 years (63.5 years in male group , respective
64.92 years in female one).
Column N%
No
23
23%
Yes
77
77%
No
67
67%
Yes
33
33%
No
31
31%
Yes
69
69%
No
19
19%
Dyslipemia
Yes
81
81%
No
48
48%
Yes
52
52%
SBP
DBP
Heart rate
Valid
100
100
99
Missing
143.36
83.64
75.20
Mean value
Frequency
Percent
ABI 0.09
31
31%
68
68%
Total
99
99%
Missing
1%
Total
100
100%
Frequency
Percent
0%
31
31%
68
68%
Total
99
99%
Missing
1%
Total
100
100%
Frequency
Percent
Acetylsalicylic acid +
Thienopyridine
Thienopyridine
Acetylsalicylic acid
Acetylsalicylic acid +
Thienopyridine + Others
No treatment
Thienopyridine + Others
Acetylsalicylic acid + Others
Others
Total
64
64%
29
4
3
29%
4%
3%
0
0
0
0
100
0%
0%
0%
0%
100%
Count
0
Column N%
0%
No
Yes
No
Yes
100
1
99
3
100%
1%
99%
3%
No
97
97%
Conclusions:
The prevalence of Peripheral Arterial Disease (PAD) based on ABI measurement in the
cohort of 100 patients admitted to hospital with diagnostic of ACS or outpatients after an
ACS (within last 6 months), ambulatory checked was of 68% ( 68 patients with ABI
values < 0.9). ABI measurement is also considered as a generalized atherosclerotic
marker that may allow identifying patients at high risk for developing cardio or
cerebrovascular events: on top of the patients with ABI values lower than 0.9 there were
those 0 ones with ABI values > 1.4 ( 0%) indicating arterial stiffness and, as already
mentioned, risk of major cardiovascular events.
The main variables associated with a higher risk of PAD that have been identified among
this population were the following risk factors: hypertension, diabetes mellitus, present
smoking or history of smoking and history of cardiovascular diseases (p values of
statistical significance are illustrated below):
Risk factors
Hypertension
Diabetes mellitus
Smoking
Dyslipemia
History CV
disease
Odd-ratio (95%CI)
0.81 (0.30-2.18)
0.83 (0.34-2.01)
0.37 (0.15-0.92)
2.87 (0.77-10.70)
0.69 (0.29-1.61)
Risk-ratio(95%CI)
0.95 (0.74-1.21)
0.89 (0.51-1.56)
0.71 (0.50-1.01)
1.18 (0.99-1.40)
0.83 (0.53-1.29)
X2
X2
uncorrected
used
0.16
0.16
4.71
2.63
0.72
0.16
0.15
4.67
2.60
0.72
The logistic regression calculation (taking into account all these risk factors
simultaneously)identified that hypertension, diabetes mellitus, present smoking or history
of smoking,dyslipemia as well as history of cardiovascular disease are all risk factors
with major impact on Peripheral Arterial Disease induction.
4% of the major cardiovascular events (vascular death, myocardial infarction and
stroke/TIA)occurred during the 6 months of follow up in the group of patients with ABI
values < 0.9 and 0 % in those with normal ABI values.
100% of the patients were on antiplatelet treatment at the inclusion visit: 71%
acetylsalicylic acid, 96 % thienopyridine and 3 % others, as monotherapy or in
combinations.
p-value
0.31
0.35
0.018
0.05
0.20