Relationship between site of initial symptoms and subsequent progression of disease in a prospective study of atherosclerosis progression in patients receiving long-term treatment for symptomatic peripheral arterial disease.

摘要: Purpose There have been few studies of the natural history peripheral arterial disease (PAD), and none used serial noninvasive laboratory examinations for objective quantification progression. The relationship between site initial symptoms PAD (lower-extremity [LED] vs cerebrovascular [CVD]) subsequent symptomatic progression (LED CVD coronary heart [CHD]) has not examined. Methods This is a long-term, blinded prospective clinical research study to multiple clinical, laboratory, vascular parameters. Patients with LED, CVD, or both underwent comprehensive risk-factor assessment were seen every 6 months follow-up examinations. In addition physical examination, all subjects lower-extremity carotid artery testing. site(s) was examined by means multivariate proportional hazards analysis, which adjusted age, diabetes mellitus, hypertension, smoking, cholesterol, homocysteine level, lowest ankle/brachial index (ABI), worst stenosis, ABI progression, stenosis because each these factors significantly associated one more aspects Results 397 (mean 66 years; 38% women) mean period 48.5 months. LED initially present in 88% 37% (both 25% subjects). 78 deaths, 47 (60%) caused cardiovascular (18% mortality rate after 5 years life table). Progression as documented findings occurred 90% table (ABI 31%; 40%). Symptomatic 52% 22%; 23%; CHD 31%). By no significant found CHD; P = hazard ratios). Conclusion experience ongoing frequency that influenced their original symptoms. hypothesis lesions resulting systemic atherosclerosis occur at various anatomic sites matter random chance should be tested other studies.