Survival and event-free survival of patients with peripheral arterial disease undergoing prevention of cardiovascular disease

Abstract

Background: Patients with peripheral arterial disease (PAD) are at very high risk for cardiovascular events. How do patients with PAD differ from age- and sex-matched controls in survival, major ischemic events and revascularization procedures when both groups were managed according to the European guidelines on cardiovascular disease prevention?

Methods: Patients with PAD (N.=742) and 713 age and sex-matched control subjects without PAD, both groups aged 65±9 years at inclusion, were managed for 5 years according to the European guidelines on cardiovascular disease prevention and evaluated yearly for occurrence of death, non-fatal major ischemic events and revascularization procedures (minor events).

Results: In the PAD group, the 5-year survival was 84.7% (CI 82.1-87.3%) vs. 93.3% (CI 91.5-95.2%) in the control group, P<0.001. In the PAD group the proportion of cardiovascular deaths did not differ significantly from non-cardiovascular deaths (6.9 vs. 8.4%, P=0.14), while in the control group cardiovascular deaths were less frequent (2.4 vs. 4.3%, P=0.05). The groups differed in 5-year major event-free survival: 76.7% (CI 73.7-79.8%) in PAD vs. 89.9% (CI 87.7 -92.2%) in controls, P<0.001, and in event-free survival: 56.2% (CI 52.7-59.9%) in PAD vs. 82.4% (CI 79.9-85.3%) in controls, P<0.001.

Conclusions: Patients with PAD had a higher risk of all-cause death, major and minor non-fatal cardiovascular events compared to control subjects. In our group, cardiovascular events were not the leading cause of death in patients with PAD (ClinicalTrials.gov number NCT00761969.).