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Associations of Symptomatic or Asymptomatic Peripheral Arterial Disease with All-Cause and Cardiovascular Mortality after 3 Years Follow Up: The China Ankle-Brachial Index Cohort Study

Abstract

Xiankai Li, Yidong Wei, DachunXu, Yang Han, Chang Liang, Jianying Shen, Ji Zhang, Yingyi Luo, Dayi Hu, Jue Li and Yawei Xu

Objective: This study aim to investigate all cause and cardiovascular mortality in Chinese in patients with symptomatic or asymptomatic Peripheral Arterial Disease (PAD) in comparison to those without PAD.

Methods: All the subjects were inpatients at high risk of atherosclerosis and consecutively enrolled from July to November, 2004. A total of 3210 were followed up until an end-point was reached or until February 2008.The mean follow-up time was 38 ± 2 months.

Results: Compared with non-PAD, PAD patients had significantly higher frequency of coronary artery disease, hypertension, diabetes mellitus, dyslipidemia, stroke or smoking (all P<0.01). The all cause mortality and cardiovascular mortality in patients with PAD were 25.5% and 15.6%, respectively. Those with symptomatic and asymptomatic PAD had a statistically significant higher all cause and cardiovascular mortality compared to those without PAD (P<0.01).The symptomatic PAD patients were 1.834 times (95% CI: 1.225-2.746) as likely to die as those without PAD, and 1.650 times (95% CI: 1.303-2.088) in asymptomatic PAD patients after adjusting for other factors. Those with symptomatic or asymptomatic PAD had more than twice as likely to die of cardiovascular disease as those without PAD (RR: 2.243, 95% CI: 1.363-3.691 and RR: 2.100, 95% CI: 1.561-2.824, respectively).

Conclusion: In comparison to non-PAD patients, those with PAD were associated with a higher all cause and cardiovascular mortality whether or not PAD is symptomatic. ABI as a marker of atherosclerosis should be routinely done to evaluate PAD in elder patients in China.