Abstract 3120: Long-term Prognosis Of Patients With Peripheral Arterial Disease; A Comparison With A Matched Population Of Patients With Coronary Artery Disease
OBJECTIVE: To compare long-term outcome of patients with peripheral arterial disease (PAD), with a matched population of coronary artery disease (CAD) patients, but without PAD.
METHODS: A total of 2,730 PAD patients were grouped into:
carotid endarterectomy (n=560);
elective abdominal aortic surgery (AAA, n=923);
acute AAA surgery (n=200) and
lower limb arterial reconstructions (LLR, n=1,047).
All patients were matched using the propensity score, with 15,993 CAD patients who underwent coronary angioplasty. Survival status of all patients was obtained. In addition, the cause of death and complications after surgery in PAD patients was noted. Kaplan-Meier method was used to compare survival between the matched PAD and CAD population and the different operation groups. Prognostic risk factors and perioperative complications were identified with the Cox regression.
RESULTS: PAD patients had a worse long-term prognosis (HR 2.4, 95% CI: 2.2–2.7) and received less medication (β-blockers, statins, ACE-inhibitors, and aspirin), compared to CAD patients (all p=<0.001). Cerebro-cardiovascular complications were the major cause of long-term death (46%). No significant difference in long-term survival was observed between the AAA and LLR groups (log rank p=0.70). Perioperative cardiac complications were associated with long-term cardiac death, while non-cardiac complications were associated with all-cause death.
CONCLUSIONS: Long-term prognosis of PAD patients is significantly worse than patients with CAD, this group of patients receive less cardiac medication and cerebro-cardiovascular events are the major cause of late death.