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Predictors of outcome in stable outpatients with peripheral artery disease

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Abstract

Patients with peripheral artery disease (PAD) are at increased risk for subsequent ischemic events. We used data from the FRENA Registry to find predictors of subsequent myocardial infarction (MI), ischemic stroke, and limb amputation in stable outpatients with PAD. As of January 2012, 1,270 patients with PAD were recruited, of whom 1,042 (82 %) had Fontaine stage II; 113 (8.9 %) stage III; and 115 (9.1 %) stage IV. Over a mean follow-up of 14 months, 35 patients developed MI, 25 had stroke, 39 underwent limb amputation, and 91 died. Among patients with Fontaine stage II, the incidence of MI (2.09 events per 100 patient-years; 95 % CI 1.43–2.97) or stroke (0.93; 95 % CI 0.52–1.56) was similar to that of limb amputation (3.22; 95 % CI 2.37–4.29). On multivariate analysis, patients with diabetes [hazard ratio (HR) 2.09; 95 % CI 1.05–4.18], prior coronary disease (HR 5.35; 95 % CI 2.24–12.8), or atrial fibrillation (HR 3.11; 95 % CI 1.52–6.37) were at increased risk for MI; female (HR 2.94; 95 % CI 1.32–6.67), those with prior stroke (HR 5.21; 95 % CI 1.22–22.2) or atrial fibrillation (HR 3.37; 95 % CI 1.45–7.85) at increased risk for stroke; and female (HR 2.38; 95 % CI 1.23–4.55), those with diabetes (HR 3.50; 95 % CI 1.58–7.73) or advanced stages of PAD were at increased risk for limb amputation. Prior coronary artery disease, diabetes and atrial fibrillation predicted subsequent MI; female gender, prior stroke and atrial fibrillation predicted stroke; and female gender, diabetes, and advanced stages of PAD predicted limb amputation.

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Acknowledgments

We express our gratitude to S & H Medical Science Service for their quality control, logistic and administrative support. We thank Salvador Ortíz, Prof. Universidad Autónoma de Madrid and Statistical Advisor S & H Medical Science Service for the statistical analysis of the data presented in this paper.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Hospital Universitari de Bellvitge, Barcelona, Spain

    Carmen Sanclemente

  2. Department of Vascular Surgery, Hospital de Terrassa, Terrassa, Spain

    Montserrat Yeste

  3. Department of Internal Medicine, Hospital de la Princesa, Madrid, Spain

    Carmen Suarez

  4. Department of Rehabilitation, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain

    Ramón Coll

  5. Department of Internal Medicine, Hospital de Alcañiz. Alcañiz, Teruel, Spain

    Eduardo Aguilar

  6. Department of Internal Medicine, Hospital Municipal de Badalona, Barcelona, Spain

    Joan Carles Sahuquillo

  7. Department of Vascular Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Badalona, Spain

    Rosa Lerma

  8. Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, 08916, Spain

    Manuel Monreal

Authors
  1. Carmen Sanclemente
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  2. Montserrat Yeste
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  3. Carmen Suarez
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  4. Ramón Coll
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  5. Eduardo Aguilar
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  6. Joan Carles Sahuquillo
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  7. Rosa Lerma
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  8. Manuel Monreal
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Consortia

FRENA investigators

Corresponding author

Correspondence to Manuel Monreal.

Additional information

A full list of FRENA investigators is given in the Appendix.

Appendix: Members of the FRENA Group

Appendix: Members of the FRENA Group

Aguilar E, Álvarez LR, Arnedo G, Coll R, García-Díaz A, Fuentes E, Monreal M, Mujal A, Pascual MT, Sahuquillo JC, Sánchez Muñoz-Torrero JF, Sanclemente C, Suárez C, Suriñach JM, Toril J, Yeste M.

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Sanclemente, C., Yeste, M., Suarez, C. et al. Predictors of outcome in stable outpatients with peripheral artery disease. Intern Emerg Med 9, 69–77 (2014). https://doi.org/10.1007/s11739-012-0854-1

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