Abstract 14117: Predictors of Incident Symptomatic Peripheral Arterial Disease in Stable Outpatients: The International REduction of Atherothrombosis for Continued Health (REACH) Registry
Objectives: Although epidemiological studies have identified classical risk factors that predict incident atherosclerotic disease in men and women, limited data exist on the relative contribution of other factors that may predict incident peripheral arterial disease (PAD) in outpatients. We sought to compare factors predictive of incident PAD in patients who were free of known PAD at baseline enrolled in the international, prospective REACH registry.
Methods: We compared differences in the incidence of new-onset PAD (defined by new claudication symptoms, open surgical or endovascular revascularization procedures, or ischemic amputation) between men and women, using multivariate Cox regression and adjusted for baseline variables known to influence 4-year outcomes (age, smoking, diabetes, body mass index, congestive heart failure (CHF), atherosclerosis in other distribution(s), aspirin use, statin use, timing of prior ischemic event, and geographic distribution). We also evaluated the independent predictors of incident PAD at 4-year follow-up.
Results: A total of 36,117 patients (36.8% women) completed 4-year follow-up. The overall 4-year incident PAD rate was 2.9% for men and 2.1% for women (adjusted odds ratio = 1.35, 95% confidence interval [CI] 1.22-1.49; p<0.0001). Baseline factors that were predictive of incident PAD in men were current smoking, anti-anginal use, BP ≥140/90 mm Hg, CHF, insulin-dependent diabetes (IDDM), fasting glucose ≥ 110 mg/dl, and arterial disease in other territories. In women, risk factors were current smoking, anti-anginal use and IDDM. Men and women in Japan were less likely than patients in other countries to develop PAD (Table).
Conclusions: Men with risk factors or known non-PAD atherosclerotic disease have a 35% higher risk of developing symptomatic PAD as compared with women at 4 years. Smoking, anti-anginal use and IDDM were common risk factors associated with developing symptomatic PAD in both men and women.
- © 2011 by American Heart Association, Inc.