Abstract 16481: Timeline ("Chronology") and Clinical Correlates of Early Cardiovascular Events in Adults with Premature Artery Disease
Background: The systemic nature of early subclinical atherosclerotic cardiovascular disease (ASCVD) is well established. Cardiovascular events in the young result mainly from coronary artery disease (CAD) or cerebrovascular disease (CeVD). We studied the chronology of the diagnosis of clinical ASCVD in patients (pts) with premature peripheral artery disease (PAD).
Methods: Over a period of 12 years, we treated 556 pts with severe PAD <55 years of age at diagnosis. Of these 51 pts had PAD and CAD/CeVD diagnosed simultaneously and were excluded from the analysis. Clinical characteristics were evaluated for association with diagnosis of CAD/CeVD prior to PAD, using chi-square tests (categorical) and t-test (continuous), as well as multivariable regression.
Results: At initial evaluation in our vascular center among 505 pts (age 45 ± 7 yrs; 72% smokers): 372 (74%, Group I) had PAD as their first clinical manifestation of ASCVD; 133 (26%, Group II) had CAD (97), CeVD (32), or both (4) at diagnosis of ASCVD. In Group I, 310 pts had PAD only, and 62 had other CVD prior to our evaluation (median (IQR) delay of 3 (1, 6) yrs between diagnosis of early PAD and subsequent CAD/CeVD). In Group II, (median (IQR) delay between diagnosis of CAD/CeVD and PAD was 4 (2, 6) yrs. Gender and race were comparable between 2 groups. Table shows clinical variables.
Conclusions: At diagnosis of clinical premature PAD, only 1/4 of our pts had preceding Cardiovascular events in other anatomic locations. The latter had greater association with the majority of traditional CV risks. Our findings suggest that in younger adults with PAD this is frequently their first clincal manifestation of ASCVD, and underscores the need for aggressive preventative measures.
- © 2012 by American Heart Association, Inc.